MEDICARE: CHELSEA GRESS

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1427590579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEA GRESS

Provider Business Mailing Address
First Line	:	9029 S PECOS RD STE 2700
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-7198
Country	:	US
Telephone Number	:	702-680-1526
Fax Number	:	702-303-2873

Provider Business Practice Location Address
First Line	:	9029 S PECOS RD STE 2700
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074
Country	:	US
Telephone Number	:	702-680-1526
Fax Number	:	702-303-2873

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

Provider Enumeration Date	:	11/07/2016
Last Update Date	:	05/21/2018

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Directions to “ CHELSEA GRESS ” Practice Location

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