Individual
SHERILL BANKS-MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
431 S 6TH ST, LAS VEGAS, NV 89101-6915
(702) 762-5633
(702) 749-7844
Mailing address
1058 W. OWENS AVE, LAS VEGAS, NV 89106
(702) 749-7444
(702) 749-7844
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720477755
—
NV
Enumeration date
01/14/2015
Last updated
04/24/2020
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