Provider Demographics
NPI:1558119446
Name:RECTO, EUGENE-ISAAC CONTRERAS (SLP-CFY)
Entity type:Individual
Prefix:
First Name:EUGENE-ISAAC
Middle Name:CONTRERAS
Last Name:RECTO
Suffix:
Gender:M
Credentials:SLP-CFY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10401 W CHARLESTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-1151
Mailing Address - Country:US
Mailing Address - Phone:971-224-2841
Mailing Address - Fax:971-220-1213
Practice Address - Street 1:10401 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89135-1151
Practice Address - Country:US
Practice Address - Phone:971-224-2841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3638235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist