Provider Demographics
NPI:1922391234
Name:SENTER, DONALD JAMES (BS)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:JAMES
Last Name:SENTER
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9470 PEACE WAY
Mailing Address - Street 2:UNIT 133
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8246
Mailing Address - Country:US
Mailing Address - Phone:702-327-0527
Mailing Address - Fax:
Practice Address - Street 1:9470 PEACE WAY
Practice Address - Street 2:UNIT 133
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-8246
Practice Address - Country:US
Practice Address - Phone:702-327-0527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-18
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV233978671251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV233-978671OtherREHABILITATION PRATITIONER