Doctor Name: | RAQUEL YSABEL VILLASENOR |
NPI Number: | 1386082055 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT, NCBTMB |
License Number: | MT-17744 |
Business Practice Address: | 5630 S Highway 95 #3b Fort Mohave, AZ - 864266041 |
Business Phone Number: | 4802961509 |
Business Fax Number: | |
Mailing Address: | 5630 S Highway 95, #3b FORT MOHAVE |
State: | AZ |
Postal Code: | 864266041 |
Phone Number: | 4802961509 |
Fax Number: | |
NPI Enumeration Date: | 06/04/2013 |
NPI Last Update Date: | 06/04/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MT-17744 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |