Individual
GENESIS IRAHETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1771 E FLAMINGO RD, LAS VEGAS, NV 89119-5155
(702) 560-2192
Mailing address
2120 RAMROD AVE UNIT 2217, HENDERSON, NV 89014-2021
(702) 908-1176
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/10/2022
Last updated
05/10/2022
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