Provider Demographics
NPI:1215224175
Name:VELASQUEZ, MARTHA VERONICA (BA HUMAN SERVICES)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:VERONICA
Last Name:VELASQUEZ
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Gender:F
Credentials:BA HUMAN SERVICES
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Mailing Address - Street 1:1055 E TROPICANA AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6652
Mailing Address - Country:US
Mailing Address - Phone:702-739-7716
Mailing Address - Fax:702-597-2242
Practice Address - Street 1:1055 E TROPICANA AVE STE 201
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6652
Practice Address - Country:US
Practice Address - Phone:702-739-7716
Practice Address - Fax:702-597-2242
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner