Individual
MISS STEPHANIE KRISTAL GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3950 LAS VEGAS BLVD N, LAS VEGAS, NV 89115-0598
(702) 547-6971
Mailing address
1060 WIGWAM PKWY, HENDERSON, NV 89074-8162
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
LBA0787
NV
106S00000X
Behavior Technician
RBT-19-107713
NV
Other
Enumeration date
12/04/2019
Last updated
06/20/2023
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