Provider Demographics
NPI:1154660207
Name:BROTMAN, STEVEN (BS, MS)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:BROTMAN
Suffix:
Gender:M
Credentials:BS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 N EASTERN AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-2885
Mailing Address - Country:US
Mailing Address - Phone:702-772-4864
Mailing Address - Fax:
Practice Address - Street 1:730 N EASTERN AVE STE 120
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-2885
Practice Address - Country:US
Practice Address - Phone:702-772-4864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-10
Last Update Date:2013-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEG
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health