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NPI Code Detail

MEDICARE: DENISIS VARONA CHALA

MEDICARE: DENISIS VARONA CHALA
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
1172A00000XDriver
2372600000XAdult Companion
3225600000XDance Therapist
4225800000XRecreation Therapist
5225A00000XMusic Therapist
6171M00000XCase Manager/Care Coordinator

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NV20171812693OTHERNVSOLE PROPRIETOR BUSINESS LICENSE ID

General Provider Information

NPI Number : 1649754276
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISIS VARONA CHALA
Provider Business Mailing Address
First Line : 4714 E FLAMINGO RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-4709
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4714 E FLAMINGO RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-4709
Country : US
Telephone Number : 702-685-7770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2018
Last Update Date : 11/05/2018

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Directions to “ DENISIS VARONA CHALA ” Practice Location

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