Individual
ANTIONEICE CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1785 E SAHARA AVE STE 485, LAS VEGAS, NV 89104-3757
(702) 562-2348
Mailing address
1785 E SAHARA AVE STE 485, LAS VEGAS, NV 89104-3757
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
08/23/2019
Last updated
08/23/2019
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