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General NPI Number Information
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NPI Number | 1912290180
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Entity Type | Individual
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Provider Name | KRISTEL VANASSCHE LMT
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Gender | Female
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Dates
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Enumeration Date | 05/20/2011
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Last Update Date | 05/20/2011
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Provider Practice Location Address
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Address Line | 7455 W WASHINGTON AVE SUITE 210
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City | LAS VEGAS
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State | NV
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Zip | 89128-4337
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Country | US
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Telephone | 702-539-4451
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Fax |
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Provider Business Mailing Address
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Address Line | 8490 WESTCLIFF DR SUITE 80
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City | LAS VEGAS
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State | NV
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Zip | 89145-3906
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Country | US
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Telephone | 702-539-4451
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | NVMT.4648
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License Number State | NV
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