Provider Demographics
NPI:1245302504
Name:CINTRON-CONCEPCION, AWILDA
Entity type:Individual
Prefix:MRS
First Name:AWILDA
Middle Name:
Last Name:CINTRON-CONCEPCION
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 1:10924 CIVILETTI ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-3909
Mailing Address - Country:US
Mailing Address - Phone:702-896-9362
Mailing Address - Fax:
Practice Address - Street 1:4180 S PECOS RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5074
Practice Address - Country:US
Practice Address - Phone:702-486-7529
Practice Address - Fax:702-486-6979
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management