Provider Demographics
NPI:1346507639
Name:SANCHEZ, MAYRA IVETTE
Entity Type:Individual
Prefix:MS
First Name:MAYRA
Middle Name:IVETTE
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9570 SUMMER FURNACE ST
Mailing Address - Street 2:9570 SUMMER FURNACE STREET
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-6246
Mailing Address - Country:US
Mailing Address - Phone:512-653-8311
Mailing Address - Fax:512-653-8311
Practice Address - Street 1:9570 SUMMER FURNACE ST
Practice Address - Street 2:9570 SUMMER FURNACE STREET
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89178-6246
Practice Address - Country:US
Practice Address - Phone:512-653-8311
Practice Address - Fax:512-653-8311
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner