Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 225XP0019X | NV |
NPI | 1033546536 |
---|---|
Provider Name | Devan Stevens |
First Address | Henderson, NV 89002-8824 |
Second Address | Las Vegas, NV 89106-3826 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2013 |
Last Update Date | 05/11/2018 |