Provider Demographics
NPI:1619178472
Name:SCHNEBELEN, STACEY CECILIA (OTRL)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:CECILIA
Last Name:SCHNEBELEN
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:582 SWISS COTTAGE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-1203
Mailing Address - Country:US
Mailing Address - Phone:702-505-0379
Mailing Address - Fax:
Practice Address - Street 1:582 SWISS COTTAGE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89178-1203
Practice Address - Country:US
Practice Address - Phone:702-505-0379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0738225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist