Healthcare Provider Details

I. General information

NPI: 1770497307
Provider Name (Legal Business Name): MARIBLANCA OLIU GOMEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3430 E FLAMINGO RD STE 300
LAS VEGAS NV
89121-5066
US

IV. Provider business mailing address

3430 E FLAMINGO RD STE 300
LAS VEGAS NV
89121-5066
US

V. Phone/Fax

Practice location:
  • Phone: 702-637-7535
  • Fax: 702-920-7677
Mailing address:
  • Phone: 702-637-7535
  • Fax: 702-920-7677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: