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NPI Code Detail

MEDICARE: SHERRY MAYA

MEDICARE: SHERRY MAYA
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
1253J00000XFoster Care Agency

General Provider Information

NPI Number : 1407190341
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHERRY MAYA
Provider Business Mailing Address
First Line : 3301 MOON RIVER ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-2167
Country : US
Telephone Number : 702-992-0576
Fax Number : 702-992-0391
Provider Business Practice Location Address
First Line : 3155 E PATRICK LN
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-3496
Country : US
Telephone Number : 702-992-0576
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2012
Last Update Date : 11/15/2012

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Directions to “ SHERRY MAYA ” Practice Location

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