Individual
LICET LOPEZ RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2350 S JONES BLVD, LAS VEGAS, NV 89146-3103
(702) 510-9982
Mailing address
8236 TEN GALLON CT, LAS VEGAS, NV 89129-6826
(702) 857-5810
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
07/15/2020
Last updated
07/15/2020
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