Individual
CARNELL LEMONT STUCKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4325 W ROME BLVD, 3181, N LAS VEGAS, NV 89084-5497
(309) 444-0063
Mailing address
4325 W ROME BLVD, 3181, N LAS VEGAS, NV 89084-5497
(309) 444-0063
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
225400000X
—
NV
Enumeration date
01/27/2011
Last updated
01/27/2011
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