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Individual

MISS KRISTINE LYNN DAWSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
5605 OLD STABLE AVE, LAS VEGAS, NV 89131-2061
(702) 768-4894
Mailing address
5605 OLD STABLE AVE, LAS VEGAS, NV 89131-2061

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0654
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100512190
NV
Enumeration date
01/29/2012
Last updated
01/29/2012
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