MEDICARE: ALEXANDRA DANLAG STEVENSON

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	1041C0700X	Clinical Social Worker	10791-M	NV

General Provider Information

NPI Number	:	1700444148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA DANLAG STEVENSON

Provider Business Mailing Address
First Line	:	2693 COPILICO TER
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-4821
Country	:	US
Telephone Number	:	702-881-3502
Fax Number	:

Provider Business Practice Location Address
First Line	:	3320 N BUFFALO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-7443
Country	:	US
Telephone Number	:	702-659-4825
Fax Number	:

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

Provider Enumeration Date	:	05/31/2019
Last Update Date	:	09/29/2023

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Directions to “ ALEXANDRA DANLAG STEVENSON ” Practice Location

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