Healthcare Provider Details

I. General information

NPI: 1649570862
Provider Name (Legal Business Name): MRS. MARCELA SOLEDAD AGUIRRE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2010
Last Update Date: 12/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6171 W CHARLESTON BLVD BLDG 10
LAS VEGAS NV
89146-1126
US

IV. Provider business mailing address

6616 CELESTE AVE
LAS VEGAS NV
89107-2405
US

V. Phone/Fax

Practice location:
  • Phone: 702-486-6194
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: