Provider Demographics
NPI:1316380298
Name:MARAPAO, CLYDELLE ANNE (MPT)
Entity type:Individual
Prefix:
First Name:CLYDELLE
Middle Name:ANNE
Last Name:MARAPAO
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4746 CORTINA RANCHO ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8136
Mailing Address - Country:US
Mailing Address - Phone:702-918-5635
Mailing Address - Fax:
Practice Address - Street 1:2330 PASEO DEL PRADO STE C202
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-4376
Practice Address - Country:US
Practice Address - Phone:024-899-3557
Practice Address - Fax:702-413-6333
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2754225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist