Individual
LIDUVINA CHONGSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1064 E SAHARA AVE, LAS VEGAS, NV 89104-3220
(702) 998-4865
Mailing address
3812 MELLON CT, NORTH LAS VEGAS, NV 89032-2877
(702) 218-3784
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
10/07/2020
Last updated
10/07/2020
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