Individual
BREANNA CHARNELLE BENAVIDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4344 LAGUNA GARDEN AVE, LAS VEGAS, NV 89115-6006
(702) 772-4252
Mailing address
4344 LAGUNA GARDEN AVE, LAS VEGAS, NV 89115-6006
(702) 772-4252
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
10/03/2014
Last updated
10/03/2014
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