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NPI Code Detail

MEDICARE: SEAN STEWART

MEDICARE: SEAN STEWART
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1942585435
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN STEWART
Provider Business Mailing Address
First Line : 1108 E HAMMER LN
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89081-2976
Country : US
Telephone Number : 702-326-2529
Fax Number :
Provider Business Practice Location Address
First Line : 1108 E HAMMER LN
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89081-2976
Country : US
Telephone Number : 702-326-2529
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2011
Last Update Date : 10/15/2011

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Directions to “ SEAN STEWART ” Practice Location

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