Individual
TYSHAY MONNA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRANIAL PROSTHETIC
Contact information
Practice address
3450 N HUALAPAI WAY UNIT 1058, LAS VEGAS, NV 89129-8057
(213) 909-1151
Mailing address
3450 N HUALAPAI WAY UNIT 1058, LAS VEGAS, NV 89129-8057
(213) 909-1151
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
NV
335E00000X
Prosthetic/Orthotic Supplier
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
11/07/2023
Last updated
12/04/2024
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