Individual
DR. CHAQULA POINTER-KALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DM-ODC, MA-HPS/EDU
Contact information
Practice address
3720 AUTZEN STADIUM WAY, LAS VEGAS, NV 89115-1568
(662) 573-2002
Mailing address
3720 AUTZEN STADIUM WAY, LAS VEGAS, NV 89115-1568
(662) 573-2002
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
01/07/2014
Last updated
08/13/2019
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