Healthcare Provider Details

I. General information

NPI: 1528435476
Provider Name (Legal Business Name): MRS. STARLYN LAA-PALACAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2015
Last Update Date: 08/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 PINTO LN
LAS VEGAS NV
89106-4019
US

IV. Provider business mailing address

328 W BOSTON AVE APT 1
LAS VEGAS NV
89102-5203
US

V. Phone/Fax

Practice location:
  • Phone: 702-816-3658
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: