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General NPI Number Information
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NPI Number | 1790238194
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Entity Type | Individual
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Provider Name | KRISTEN-SHAWN SENSANO PANEM
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Gender | Female
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Dates
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Enumeration Date | 08/02/2016
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Last Update Date | 08/02/2016
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Provider Practice Location Address
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Address Line | 2350 S JONES BLVD STE. 100
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City | LAS VEGAS
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State | NV
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Zip | 89146-3103
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Country | US
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Telephone | 702-496-1367
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Fax |
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Provider Business Mailing Address
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Address Line | 2350 S JONES BLVD STE. 100
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City | LAS VEGAS
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State | NV
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Zip | 89146-3103
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Country | US
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Telephone | 702-496-1367
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number | RBT-16-21512
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License Number State | NV
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