Individual
STEPHANIE ANN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5625 BOLTON VALLEY DR, LAS VEGAS, NV 89122-5200
(702) 771-1098
Mailing address
5625 BOLTON VALLEY DR, LAS VEGAS, NV 89122-5200
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
12/06/2022
Last updated
12/06/2022
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