Provider Demographics
NPI:1336340942
Name:LIM, MYLYNN CUEVAS (PT)
Entity Type:Individual
Prefix:
First Name:MYLYNN
Middle Name:CUEVAS
Last Name:LIM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MYLYNN
Other - Middle Name:CARTERA
Other - Last Name:CUEVAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:7127 LOS BANDEROS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89179-1207
Mailing Address - Country:US
Mailing Address - Phone:702-769-2382
Mailing Address - Fax:702-361-6348
Practice Address - Street 1:7127 LOS BANDEROS AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89179-1207
Practice Address - Country:US
Practice Address - Phone:702-769-2382
Practice Address - Fax:702-361-6348
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1782225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist