Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1336539238 |
---|---|
Provider Name | Mauriecia Sewell |
First Address | Henderson, NV 89015-5424 |
Second Address | North Las Vegas, NV 89032-8212 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2015 |
Last Update Date | 29/01/2015 |