Provider Demographics
NPI:1689948457
Name:TAFUA, ISAIAH LAFI (QMHA)
Entity Type:Individual
Prefix:
First Name:ISAIAH
Middle Name:LAFI
Last Name:TAFUA
Suffix:
Gender:M
Credentials:QMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2920 N GREEN VALLEY PKWY
Mailing Address - Street 2:BLDG #6, SUITE 642
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-0406
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2920 N GREEN VALLEY PKWY
Practice Address - Street 2:BLDG #6, SUITE 642
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-0406
Practice Address - Country:US
Practice Address - Phone:702-489-9946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-26
Last Update Date:2012-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner