Individual
MARK STUCKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6650 E RUSSELL RD # R, LAS VEGAS, NV 89122-8359
(702) 408-2323
Mailing address
6650 E RUSSELL RD # R, LAS VEGAS, NV 89122-8359
(702) 408-2323
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0
—
NV
Enumeration date
12/13/2013
Last updated
12/13/2013
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