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5828 Spring Mountain Rd Ste 318 Las Vegas NV 89146-8896 | |
| (702) 485-6705 | |
| (702) 485-6706 |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 5828 Spring Mountain Rd Ste 318, Las Vegas, Nevada |
| Authorized Official Name and Position | Richard Joseph Thomson (SECRETARY, TREASURER) |
| Authorized Official Contact | 7024856705 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5828 Spring Mountain Rd Ste 318 Las Vegas NV 89146-8896 Ph: (702) 485-6705 | 5828 Spring Mountain Rd Ste 318 Las Vegas NV 89146-8896 Ph: (702) 485-6705 |
| NPI Number | 1871975680 |
|---|---|
| Provider Enumeration Date | 06/29/2015 |
| Last Update Date | 06/29/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871975680 | NPI | - | NPPES |
| 103K00000X | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | LBA0041 (Nevada) | Primary |
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