Individual
MARIO DE SOUZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6584 ISOLATED AVE, LAS VEGAS, NV 89110-5157
(702) 332-3581
Mailing address
6584 ISOLATED AVE, LAS VEGAS, NV 89110-5157
(702) 332-3581
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/02/2016
Last updated
02/02/2016
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