Healthcare Provider Details

I. General information

NPI: 1477905164
Provider Name (Legal Business Name): STEPHANIE SAYO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2850 W HORIZON RIDGE PKWY STE 200
HENDERSON NV
89052-4395
US

IV. Provider business mailing address

2850 W HORIZON RIDGE PKWY STE 200
HENDERSON NV
89052-4395
US

V. Phone/Fax

Practice location:
  • Phone: 702-430-4590
  • Fax: 702-430-4501
Mailing address:
  • Phone: 702-430-4590
  • Fax: 702-430-4501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: