Individual
IVON CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1060 WIGWAM PKWY, HENDERSON, NV 89074-8162
(702) 847-6401
Mailing address
1060 WIGWAM PKWY, HENDERSON, NV 89074-8162
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NV
Other
Enumeration date
09/05/2020
Last updated
09/05/2020
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