Individual
EVELINA BLODGETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
714 E SAHARA AVE, LAS VEGAS, NV 89104-2942
(702) 369-8700
Mailing address
447 LEIGHANN RD, HENDERSON, NV 89015-6807
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
00859
NV
Other
Enumeration date
04/19/2012
Last updated
04/19/2012
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