Individual
MRS. MARIE ROSELLE DESEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7375 PRAIRIE FALCON RD STE 120, LAS VEGAS, NV 89128-0810
(702) 869-4401
(702) 869-9904
Mailing address
7375 PRAIRIE FALCON RD STE 120, LAS VEGAS, NV 89128-0810
(702) 869-4401
(702) 869-9904
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
294504
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
294504
MEDICARE ID-TYPE
NV
Enumeration date
05/11/2015
Last updated
05/12/2015
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