Individual
MARIELLENA MARISCAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2977 GUNNERY FORGE ST, LAS VEGAS, NV 89156-3784
(760) 829-8183
Mailing address
2977 GUNNERY FORGE ST, LAS VEGAS, NV 89156-3784
(760) 829-8183
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-406072
NV
Other
Enumeration date
01/23/2025
Last updated
01/23/2025
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