Individual
PATRICIA SELF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
4905 ROYAL LAKE AVE, LAS VEGAS, NV 89131-3684
(435) 525-1216
Mailing address
4905 ROYAL LAKE AVE, LAS VEGAS, NV 89131-3684
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
Z12200
LA
Other
Enumeration date
07/21/2009
Last updated
11/22/2014
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