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NPI Code Detail

MEDICARE: ETHEL A SANFT

MEDICARE: ETHEL A SANFT
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 : 1831978311
Entity Type Code : Individual
Provider Name (Legal Business Name) : ETHEL A SANFT
Provider Business Mailing Address
First Line : 3531 E RUSSELL RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-2245
Country : US
Telephone Number : 702-547-9819
Fax Number :
Provider Business Practice Location Address
First Line : 3531 E RUSSELL RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-2245
Country : US
Telephone Number : 702-547-9819
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2023
Last Update Date : 03/26/2026

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Directions to “ ETHEL A SANFT ” Practice Location

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