Individual
MRS. VICKY CERVANTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9125 SHALLCROSS WAY, RALEIGH, NC 27617
(919) 645-7690
Mailing address
9125 SHALLCROSS WAY, RALEIGH, NC 27617
(919) 645-7690
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
05/18/2011
Last updated
05/25/2015
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