Provider Demographics
NPI:1871355594
Name:BEVANS, JAMEICE TASHAE
Entity type:Individual
Prefix:MS
First Name:JAMEICE
Middle Name:TASHAE
Last Name:BEVANS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JAY
Other - Middle Name:
Other - Last Name:BEVANS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7390 W SAHARA AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2765
Mailing Address - Country:US
Mailing Address - Phone:702-900-4320
Mailing Address - Fax:
Practice Address - Street 1:7390 W SAHARA AVE STE 260
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2765
Practice Address - Country:US
Practice Address - Phone:702-900-4320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician