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General NPI Number Information
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NPI Number | 1255204707
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Entity Type | Individual
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Provider Name | MARILOU DELA VEGA
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Gender | Female
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Dates
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Enumeration Date | 09/29/2025
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 1601 E KATIE AVE APT 126
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City | LAS VEGAS
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State | NV
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Zip | 89119-8138
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Country | US
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Telephone | 702-809-6742
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Fax |
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Provider Business Mailing Address
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Address Line | 7920 JASPENCE ST
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City | LAS VEGAS
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State | NV
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Zip | 89166-5179
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Country | US
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Telephone | 702-727-7288
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State | NV
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