Individual
ANA MIRIAM MANTILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ND
Contact information
Practice address
2851 N TENAYA WAY, LAS VEGAS, NV 89128-0435
(702) 658-0204
(702) 658-7177
Mailing address
1275 MORNING SUN WAY, LAS VEGAS, NV 89110-2003
(702) 643-7336
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
2006305-062-121
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2006305-062-121
—
NV
Enumeration date
09/21/2022
Last updated
09/21/2022
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