MEDICARE: MAURIECIA SEWELL

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	225C00000X	Rehabilitation Counselor

General Provider Information

NPI Number	:	1336539238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAURIECIA SEWELL

Provider Business Mailing Address
First Line	:	301 TAYLOR ST
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89015-5424
Country	:	US
Telephone Number	:	323-314-2699
Fax Number	:

Provider Business Practice Location Address
First Line	:	3550 W CHEYENNE AVE STE 130N
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-8212
Country	:	US
Telephone Number	:	702-570-5201
Fax Number	:

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

Provider Enumeration Date	:	01/29/2015
Last Update Date	:	01/29/2015

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Directions to “ MAURIECIA SEWELL ” Practice Location

Language	Start Address	Practice Location

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