Individual
JERICKA STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2191 PINETOP LN UNIT 102, LAS VEGAS, NV 89119-7818
(702) 986-3164
Mailing address
2755 E DESERT INN RD STE 180, LAS VEGAS, NV 89121-3694
(702) 986-3164
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1403168525
—
NV
Enumeration date
03/03/2020
Last updated
03/03/2020
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