Provider Demographics
NPI:1508355322
Name:LAMOURIA, MALETICIA
Entity Type:Individual
Prefix:
First Name:MALETICIA
Middle Name:
Last Name:LAMOURIA
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 1:8290 W SAHARA AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-8933
Mailing Address - Country:US
Mailing Address - Phone:702-262-9949
Mailing Address - Fax:
Practice Address - Street 1:8290 W SAHARA AVE STE 260
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-8933
Practice Address - Country:US
Practice Address - Phone:702-262-9949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant