Provider Demographics
NPI:1619552791
Name:ALDANAS-GARCIA, LORAINE
Entity Type:Individual
Prefix:
First Name:LORAINE
Middle Name:
Last Name:ALDANAS-GARCIA
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 1:5152 AIRDRIE PL
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89122-6811
Mailing Address - Country:US
Mailing Address - Phone:702-978-1078
Mailing Address - Fax:
Practice Address - Street 1:3430 E TROPICANA AVE STE 52
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-7349
Practice Address - Country:US
Practice Address - Phone:702-695-3163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician