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General NPI Number Information
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NPI Number | 1316380298
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Entity Type | Individual
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Provider Name | CLYDELLE ANNE MARAPAO MPT
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Gender | Female
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Dates
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Enumeration Date | 04/10/2013
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Last Update Date | 05/13/2024
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Provider Practice Location Address
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Address Line | 2330 PASEO DEL PRADO STE C202
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City | LAS VEGAS
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State | NV
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Zip | 89102-4376
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Country | US
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Telephone | 24-899-3557
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Fax | 702-413-6333
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Provider Business Mailing Address
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Address Line | 4746 CORTINA RANCHO ST
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City | LAS VEGAS
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State | NV
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Zip | 89147-8136
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Country | US
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Telephone | 702-918-5635
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2754
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License Number State | NV
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