Provider Demographics
NPI:1134547003
Name:MCCLAIN, SEDENA
Entity type:Individual
Prefix:
First Name:SEDENA
Middle Name:
Last Name:MCCLAIN
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 1:1321 S RAINBOW BLVD
Mailing Address - Street 2:SUITE #240
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-9066
Mailing Address - Country:US
Mailing Address - Phone:702-773-1824
Mailing Address - Fax:
Practice Address - Street 1:1321 S RAINBOW BLVD
Practice Address - Street 2:SUITE #240
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-9066
Practice Address - Country:US
Practice Address - Phone:702-826-3219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-28
Last Update Date:2014-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner