Healthcare Provider Details

I. General information

NPI: 1609630730
Provider Name (Legal Business Name): LAINA D ZACHARIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2024
Last Update Date: 12/07/2025
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2481 W HORIZON RIDGE PKWY STE 100
HENDERSON NV
89052-5926
US

IV. Provider business mailing address

2481 W HORIZON RIDGE PKWY STE 100
HENDERSON NV
89052-5926
US

V. Phone/Fax

Practice location:
  • Phone: 775-515-7770
  • Fax: 775-205-2105
Mailing address:
  • Phone: 775-515-7770
  • Fax: 775-205-2105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberNVMT1664
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: