Individual
MISS BOUNRATTANAPASONG PHONHNABOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
6345 S JONES BLVD STE 300, LAS VEGAS, NV 89118-3334
(702) 515-4009
(702) 553-3438
Mailing address
7425 W AZURE DR STE 140, LAS VEGAS, NV 89130-4425
(702) 515-4009
(702) 553-3438
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
213493
TX
224Z00000X
Occupational Therapy Assistant
Primary
OTA-2887
NV
Other
Enumeration date
09/01/2016
Last updated
01/07/2022
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