Provider Demographics
NPI:1699159863
Name:STENSON, KRISTANN
Entity type:Individual
Prefix:
First Name:KRISTANN
Middle Name:
Last Name:STENSON
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 1:3920 W ANN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-3839
Mailing Address - Country:US
Mailing Address - Phone:702-550-6700
Mailing Address - Fax:702-550-4872
Practice Address - Street 1:3920 W ANN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-3839
Practice Address - Country:US
Practice Address - Phone:702-550-6700
Practice Address - Fax:702-550-4872
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILS35250386961101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health