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NPI Code Detail

MEDICARE: ERIKA MACK

MEDICARE:   ERIKA  MACK
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1295604940
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIKA MACK
Provider Business Mailing Address
First Line : 1503 LAURELHURST DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-1493
Country : US
Telephone Number : 702-499-7406
Fax Number :
Provider Business Practice Location Address
First Line : 1503 LAURELHURST DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-1493
Country : US
Telephone Number : 702-499-7406
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2025
Last Update Date : 10/31/2025

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Directions to “ ERIKA MACK ” Practice Location

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