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NPI Code Detail

MEDICARE: LESLIE E MCFADDEN

MEDICARE: LESLIE E MCFADDEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1053826735
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE E MCFADDEN
Provider Business Mailing Address
First Line : 3235 S EASTERN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-3310
Country : US
Telephone Number : 702-490-9009
Fax Number : 866-737-6147
Provider Business Practice Location Address
First Line : 3235 S EASTERN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-3310
Country : US
Telephone Number : 702-490-9009
Fax Number : 866-737-6147
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2017
Last Update Date : 12/04/2017

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Directions to “ LESLIE E MCFADDEN ” Practice Location

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