Provider Demographics
NPI:1518681121
Name:OROSCO, LEA MICHELLE (BA)
Entity Type:Individual
Prefix:
First Name:LEA
Middle Name:MICHELLE
Last Name:OROSCO
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9544 NEW HARBOR AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-0703
Mailing Address - Country:US
Mailing Address - Phone:702-289-2766
Mailing Address - Fax:
Practice Address - Street 1:9544 NEW HARBOR AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-0703
Practice Address - Country:US
Practice Address - Phone:702-289-2766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator