Healthcare Provider Details

I. General information

NPI: 1699533778
Provider Name (Legal Business Name): ANDREA LLAMAS-MONROY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2024
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 N RANCHO DR STE 108
LAS VEGAS NV
89130-3151
US

IV. Provider business mailing address

3650 N RANCHO DR STE 108
LAS VEGAS NV
89130-3151
US

V. Phone/Fax

Practice location:
  • Phone: 702-990-0326
  • Fax:
Mailing address:
  • Phone: 702-990-0326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: