Individual
SAGE MATTA BONELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3310 GONI RD BLDG H, CARSON CITY, NV 89706-7917
(775) 687-0106
Mailing address
PO BOX 4220, STATELINE, NV 89449-4220
(530) 913-4273
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-2793
NV
Other
Enumeration date
11/04/2021
Last updated
11/04/2021
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