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Individual

TALIA AMALIA BROOKS GARCIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4550 W OAKEY BLVD STE 111-O, LAS VEGAS, NV 89102-1581
(702) 861-0238
(702) 938-5896
Mailing address
5320 PADUA WAY, LAS VEGAS, NV 89107-0404
(702) 472-1975

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
376J00000X
Homemaker
Primary
NV20161065817
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1821520016
NV
Enumeration date
01/24/2018
Last updated
07/24/2020
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