Provider Demographics
NPI:1952711418
Name:BENOLIRAO-COLLANTES, TONI (MPH)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:BENOLIRAO-COLLANTES
Suffix:
Gender:F
Credentials:MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 AMBER HORIZON ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-2909
Mailing Address - Country:US
Mailing Address - Phone:630-853-9252
Mailing Address - Fax:
Practice Address - Street 1:513 AMBER HORIZON ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-2909
Practice Address - Country:US
Practice Address - Phone:630-853-9252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-05
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner