Individual
STACIE WIRTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5431 ELAINA CIR, LAS VEGAS, NV 89120-1765
(702) 354-3956
Mailing address
5431 ELAINA CIR, LAS VEGAS, NV 89120-1765
(702) 354-3956
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
07/10/2024
Last updated
06/04/2025
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