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Individual

DEBORAH BENNER-MOSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1405 S NELLIS BLVD UNIT 2068, LAS VEGAS, NV 89104-5851
(702) 985-7564
Mailing address
1405 S NELLIS BLVD UNIT 2068, LAS VEGAS, NV 89104-5851
(702) 985-7564

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
NV
252Y00000X
Early Intervention Provider Agency
Primary
NV

Other

Enumeration date
09/16/2015
Last updated
09/16/2015
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