Healthcare Provider Details

I. General information

NPI: 1285186502
Provider Name (Legal Business Name): EDITH ISADORA FELD OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2016
Last Update Date: 08/01/2021
Certification Date: 08/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2435 WHOLESOME TER
HENDERSON NV
89052-5904
US

IV. Provider business mailing address

2435 WHOLESOME TER
HENDERSON NV
89052-5904
US

V. Phone/Fax

Practice location:
  • Phone: 702-379-8458
  • Fax:
Mailing address:
  • Phone: 702-379-8458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: