Organization
THERAPY SOURCE OF NEVADA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN MINNICK OTR/L (OCCUPATIONAL THERAPIST)
(702) 683-7617
Entity
Organization
Contact information
Practice address
1614 WATERFORD FALLS AVE, LAS VEGAS, NV 89123-5873
(702) 683-7617
(702) 837-3422
Mailing address
2654 W HORIZON RIDGE PKWY, SUITE B5 PMB 322, HENDERSON, NV 89052-2803
(702) 683-7617
(702) 837-3422
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0324
NV
Other
Enumeration date
02/24/2013
Last updated
02/24/2013
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