Provider Demographics
NPI:1306641519
Name:AGGERS, ALLIVIA
Entity type:Individual
Prefix:
First Name:ALLIVIA
Middle Name:
Last Name:AGGERS
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 1:10662 DAWNS MIST AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-5056
Mailing Address - Country:US
Mailing Address - Phone:725-214-8771
Mailing Address - Fax:
Practice Address - Street 1:3925 N MARTIN L KING BLVD STE 212
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-7676
Practice Address - Country:US
Practice Address - Phone:702-444-0235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management