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NPI Code Detail

MEDICARE: MILDRED SONTAG

MEDICARE:   MILDRED  SONTAG
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1730642646
Entity Type Code : Individual
Provider Name (Legal Business Name) : MILDRED SONTAG
Provider Business Mailing Address
First Line : 3921 WHITE CASTLE ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-7076
Country : US
Telephone Number : 702-907-9882
Fax Number :
Provider Business Practice Location Address
First Line : 3921 WHITE CASTLE ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-7076
Country : US
Telephone Number : 702-907-9882
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2019
Last Update Date : 04/08/2019

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Directions to “ MILDRED SONTAG ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.