Individual
SOFIA TICAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6600 W CHARLESTON BLVD STE 101, LAS VEGAS, NV 89146-1067
(702) 690-1865
Mailing address
6600 W CHARLESTON BLVD STE 101, LAS VEGAS, NV 89146-1067
(702) 690-1865
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
680240156
NV
225700000X
Massage Therapist
Primary
NVMT6406
NV
Other
Enumeration date
07/28/2015
Last updated
01/10/2024
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