Provider Demographics
NPI:1386995884
Name:RELEFORD, AFRICA NICHOL
Entity type:Individual
Prefix:
First Name:AFRICA
Middle Name:NICHOL
Last Name:RELEFORD
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 1:4455 E TWAIN AVE
Mailing Address - Street 2:APT 155
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-4657
Mailing Address - Country:US
Mailing Address - Phone:702-768-1005
Mailing Address - Fax:
Practice Address - Street 1:4455 E TWAIN AVE
Practice Address - Street 2:APT 155
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-4657
Practice Address - Country:US
Practice Address - Phone:702-768-1005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner