Healthcare Provider Details

I. General information

NPI: 1487435608
Provider Name (Legal Business Name): NOEMI JUANITA TORRES ALEJANDRE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2023
Last Update Date: 03/13/2024
Certification Date: 03/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 N MARYLAND PKWY
LAS VEGAS NV
89101-3133
US

IV. Provider business mailing address

2200 S FORT APACHE RD UNIT 1226
LAS VEGAS NV
89117-5714
US

V. Phone/Fax

Practice location:
  • Phone: 702-789-7282
  • Fax:
Mailing address:
  • Phone: 702-428-4126
  • 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: