Individual
JUDITH ISHIBASHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR,L
Contact information
Practice address
150 W HUFFAKER LN, 105, RENO, NV 89511-2092
(775) 852-4342
Mailing address
150 W HUFFAKER LN, 105, RENO, NV 89511-2092
(775) 852-4342
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0001
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003416024
—
NV
Enumeration date
11/21/2006
Last updated
12/29/2011
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