MEDICARE: STEPHEN FIFE PH.D.

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
1	106H00000X	Marriage & Family Therapist	R03314	NV

General Provider Information

NPI Number	:	1144489964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN FIFE PH.D.

Provider Business Mailing Address
First Line	:	2649 W HORIZON RIDGE PKWY
Second Line	:	SUITE 130
City	:	HENDERSON
State	:	NV
Zip	:	89052-4801
Country	:	US
Telephone Number	:	702-380-3290
Fax Number	:

Provider Business Practice Location Address
First Line	:	2649 W HORIZON RIDGE PKWY
Second Line	:	SUITE 130
City	:	HENDERSON
State	:	NV
Zip	:	89052-4801
Country	:	US
Telephone Number	:	702-380-3290
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2008
Last Update Date	:	06/06/2008

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Directions to “ STEPHEN FIFE PH.D.” Practice Location

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