Individual
ALICIA DAWN PORTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6401 DIEGO DR, LAS VEGAS, NV 89156-7071
(702) 569-8203
Mailing address
6401 DIEGO DR, LAS VEGAS, NV 89156-7071
(702) 569-8203
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
01/23/2014
Last updated
01/23/2014
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