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General NPI Number Information
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NPI Number | 1568285013
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Entity Type | Individual
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Provider Name | MERON B SHIFERAW
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Gender | Female
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 253 CAMELBACK RIDGE AVE
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City | HENDERSON
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State | NV
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Zip | 89012-2255
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Country | US
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Telephone | 702-781-3274
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Fax |
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Provider Business Mailing Address
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Address Line | 8000 SPRING MOUNTAIN RD APT 2102
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City | LAS VEGAS
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State | NV
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Zip | 89117-3937
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Country | US
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Telephone | 725-275-6706
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-24-333937
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License Number State | NV
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