Provider Demographics
NPI:1932446143
Name:SANGREY BONNEFOY, LISA
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:SANGREY BONNEFOY
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 1:868 WINTERSWEET RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-2402
Mailing Address - Country:US
Mailing Address - Phone:702-281-9300
Mailing Address - Fax:702-220-9519
Practice Address - Street 1:868 WINTERSWEET RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-2402
Practice Address - Country:US
Practice Address - Phone:702-281-9300
Practice Address - Fax:702-220-9519
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner