Provider Demographics
NPI:1265735773
Name:DEVEAUX, BARBARA A
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:DEVEAUX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:A
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7860 W SAHARA AVE
Mailing Address - Street 2:SUITE #170
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-1944
Mailing Address - Country:US
Mailing Address - Phone:702-622-8913
Mailing Address - Fax:
Practice Address - Street 1:7860 W SAHARA AVE
Practice Address - Street 2:SUITE #170
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1944
Practice Address - Country:US
Practice Address - Phone:702-622-8913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner