Individual
LISA VANAGEATIGUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
11091 KILKERRAN CT, LAS VEGAS, NV 89141-4356
(702) 672-4104
Mailing address
7556 GRIST MILL CT, LAS VEGAS, NV 89113-1143
(415) 706-0406
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-2725
NV
Other
Enumeration date
05/20/2021
Last updated
05/20/2021
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