Individual
JISSECA LIEZEL SANTILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
315 RECORD ST STE 100, RENO, NV 89512-3327
(775) 405-4111
(775) 688-5878
Mailing address
6402 MAE ANNE AVE APT 8, RENO, NV 89523-1785
Taxonomy
Speciality
Code
Description
License number
State
246YR1600X
Registered Record Administrator
Primary
—
NV
Other
Enumeration date
05/02/2022
Last updated
05/02/2022
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