Provider Demographics
NPI:1578273413
Name:SEYMOUR, TRANIECE
Entity Type:Individual
Prefix:
First Name:TRANIECE
Middle Name:
Last Name:SEYMOUR
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 1:4617 GOLDFIELD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-2523
Mailing Address - Country:US
Mailing Address - Phone:702-423-0081
Mailing Address - Fax:
Practice Address - Street 1:701 N STOCKTON HILL RD STE P
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86401-7103
Practice Address - Country:US
Practice Address - Phone:702-423-0081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician