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NPI Code Detail

MEDICARE: YVONNE PENKALSKI

MEDICARE:   YVONNE  PENKALSKI
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
1225C00000XRehabilitation Counselor

General Provider Information

NPI Number : 1619314275
Entity Type Code : Individual
Provider Name (Legal Business Name) : YVONNE PENKALSKI
Provider Business Mailing Address
First Line : 3686 RED ROCK ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-1226
Country : US
Telephone Number : 702-686-4983
Fax Number :
Provider Business Practice Location Address
First Line : 3686 RED ROCK ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-1226
Country : US
Telephone Number : 702-686-4983
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2013
Last Update Date : 05/22/2013

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Directions to “ YVONNE PENKALSKI ” Practice Location

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