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Individual

ASMAYT DEBRETSION

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4850 W FLAMINGO RD, LAS VEGAS, NV 89103-3705
(702) 871-9917
Mailing address
589 SIERRA VISTA DR APT 8, LAS VEGAS, NV 89169-3739

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1605726926
NEVADA ID
NV
Enumeration date
09/19/2019
Last updated
09/19/2019
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