Individual
JESSICA JASMIN PORTILLO POLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6771 W CHARLESTON BLVD STE C, LAS VEGAS, NV 89146-9016
(702) 405-8772
Mailing address
3613 WOODGLEN CT, LAS VEGAS, NV 89108-1161
(702) 493-5786
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/08/2024
Last updated
06/03/2025
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