Individual
LARISSA ARCHIBEQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
408 S JONES BLVD, LAS VEGAS, NV 89107-2658
(702) 321-7549
Mailing address
5028 S RAINBOW BLVD UNIT 206, LAS VEGAS, NV 89118-0664
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NV
Other
Enumeration date
02/19/2018
Last updated
02/19/2018
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