Healthcare Provider Details

I. General information

NPI: 1851981484
Provider Name (Legal Business Name): DAYSI MERCEDES CHIQUI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2021
Last Update Date: 01/18/2021
Certification Date: 01/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4760 S PECOS RD STE 203-1
LAS VEGAS NV
89121-6038
US

IV. Provider business mailing address

4640 BRANDONKANE LN APT D
LAS VEGAS NV
89121-1999
US

V. Phone/Fax

Practice location:
  • Phone: 702-601-2697
  • Fax:
Mailing address:
  • Phone: 425-591-8910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: