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NPI Code Detail

MEDICARE: ELIZABETH JEFFREY

MEDICARE: ELIZABETH JEFFREY
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1528956380
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH JEFFREY
Provider Business Mailing Address
First Line : 1817 ARCH STONE AVE
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-5095
Country : US
Telephone Number : 503-305-0598
Fax Number :
Provider Business Practice Location Address
First Line : 6390 W CHEYENNE AVE STE D
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-6009
Country : US
Telephone Number : 702-763-5311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2025
Last Update Date : 06/27/2025

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