Individual
AMANDA MAITE CONSTANTIN FRIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
711 BLUE BARREL ST, HENDERSON, NV 89011-2616
(702) 937-2848
Mailing address
711 BLUE BARREL ST, HENDERSON, NV 89011-2616
(702) 937-2848
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01528856748
ID
NV
Enumeration date
12/03/2019
Last updated
12/03/2019
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