Individual
GENESIS ADILENE VILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2109 N MICHAEL WAY, LAS VEGAS, NV 89108-3173
(818) 391-2741
Mailing address
2109 N MICHAEL WAY, LAS VEGAS, NV 89108-3173
(818) 391-2741
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-247856
CA
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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