Individual
RAQUEL YSABEL VILLASENOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, NCBTMB
Contact information
Practice address
5630 S HIGHWAY 95, #3B, FORT MOHAVE, AZ 86426-6041
(480) 296-1509
Mailing address
5630 S HIGHWAY 95, #3B, FORT MOHAVE, AZ 86426-6041
(480) 296-1509
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT-17744
AZ
Other
Enumeration date
06/04/2013
Last updated
06/04/2013
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