Individual
RAYVON DASEAN THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3628 DOVE LN, NORTH LAS VEGAS, NV 89032-0477
(702) 505-5047
Mailing address
3628 DOVE LN, NORTH LAS VEGAS, NV 89032-0477
(702) 505-5047
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000
—
NV
Enumeration date
09/29/2014
Last updated
09/29/2014
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