MEDICARE: ALMA VERONICA DOUGLAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	OTA-2983	NV

General Provider Information

NPI Number	:	1255224390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALMA VERONICA DOUGLAS

Provider Business Mailing Address
First Line	:	114 BOYSENBERRY LN
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-2444
Country	:	US
Telephone Number	:	702-488-4397
Fax Number	:

Provider Business Practice Location Address
First Line	:	2580 MONTESSOURI ST STE 101
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-3065
Country	:	US
Telephone Number	:	716-807-4179
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2025
Last Update Date	:	05/29/2025

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Directions to “ ALMA VERONICA DOUGLAS ” Practice Location

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