Provider Demographics
NPI:1619447174
Name:SHEFLER, KASANDRA LOUISE
Entity Type:Individual
Prefix:
First Name:KASANDRA
Middle Name:LOUISE
Last Name:SHEFLER
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 1:704 SUGUARO BLUFFS ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-2671
Mailing Address - Country:US
Mailing Address - Phone:928-830-8229
Mailing Address - Fax:
Practice Address - Street 1:4660 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6137
Practice Address - Country:US
Practice Address - Phone:702-907-9275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst