Provider Demographics
NPI:1760156749
Name:GUESE, CECILLE TOLENTINO
Entity Type:Individual
Prefix:
First Name:CECILLE
Middle Name:TOLENTINO
Last Name:GUESE
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 1:1861 ARDILEA ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-3336
Mailing Address - Country:US
Mailing Address - Phone:702-927-8935
Mailing Address - Fax:
Practice Address - Street 1:5576 S FORT APACHE RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-3606
Practice Address - Country:US
Practice Address - Phone:702-371-4685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-04
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist