MEDICARE: MECHELLE PATTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1457975534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MECHELLE PATTON

Provider Business Mailing Address
First Line	:	3536 SUMMERSPRINGS DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-6396
Country	:	US
Telephone Number	:	702-767-0735
Fax Number	:

Provider Business Practice Location Address
First Line	:	1320 SHARON RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-2049
Country	:	US
Telephone Number	:	702-767-0735
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2020
Last Update Date	:	06/03/2020

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Directions to “ MECHELLE PATTON ” Practice Location

Language	Start Address	Practice Location

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