Individual
CHANDA L HAZELWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4760 S PECOS RD # 103-25, LAS VEGAS, NV 89121-5828
(702) 772-9346
(702) 446-8465
Mailing address
343 ABBINGTON ST, HENDERSON, NV 89074-4931
(702) 772-9346
(702) 446-8465
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9005054570
—
NV
Enumeration date
09/01/2011
Last updated
09/01/2011
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