Provider Demographics
NPI:1144802901
Name:STEVENS, KAYLANI LILLIAN
Entity type:Individual
Prefix:MRS
First Name:KAYLANI
Middle Name:LILLIAN
Last Name:STEVENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1784 REDWOOD ST
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-2536
Mailing Address - Country:US
Mailing Address - Phone:775-777-6816
Mailing Address - Fax:
Practice Address - Street 1:1784 REDWOOD ST
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-2536
Practice Address - Country:US
Practice Address - Phone:775-777-6816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician