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General NPI Number Information
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NPI Number | 1437941341
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Entity Type | Organization
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Legal Business Name | M D DEVELOPMENTAL AGENCY LLC
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Dates
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Enumeration Date | 05/19/2025
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 2520 SAINT ROSE PKWY # H2-216
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City | HENDERSON
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State | NV
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Zip | 89074-7783
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Country | US
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Telephone | 702-268-8513
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Fax | 702-852-0430
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Provider Business Mailing Address
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Address Line | 2520 SAINT ROSE PKWY # H2-216
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City | HENDERSON
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State | NV
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Zip | 89074-7783
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Country | US
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Telephone | 702-268-8513
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Fax | 702-852-0430
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Authorized Official
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Title or Position | CO-OWNER
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Name | DEBRA STEWART
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Credential |
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Telephone | 773-407-7558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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