Provider Demographics
NPI:1962830372
Name:PERLAS, NONETTE
Entity Type:Individual
Prefix:
First Name:NONETTE
Middle Name:
Last Name:PERLAS
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 1:4310 CAMERON ST
Mailing Address - Street 2:#11
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-3826
Mailing Address - Country:US
Mailing Address - Phone:702-540-1966
Mailing Address - Fax:
Practice Address - Street 1:4310 CAMERON ST
Practice Address - Street 2:#11
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-3826
Practice Address - Country:US
Practice Address - Phone:702-540-1966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-22
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner