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NPI Code Detail

MEDICARE: MELANIE JEWEL REYNOSO RBT

MEDICARE: MELANIE JEWEL REYNOSO RBT
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 TechnicianRBT-20-143713NV

General Provider Information

NPI Number : 1316542582
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELANIE JEWEL REYNOSO RBT
Provider Business Mailing Address
First Line : 1091 S CIMARRON RD STE A4
Second Line :
City : LAS VEGAS
State : NV
Zip : 89145-2445
Country : US
Telephone Number : 702-992-7908
Fax Number :
Provider Business Practice Location Address
First Line : 1091 S CIMARRON RD STE A4
Second Line :
City : LAS VEGAS
State : NV
Zip : 89145-2445
Country : US
Telephone Number : 702-992-7908
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2020
Last Update Date : 02/10/2025

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Directions to “ MELANIE JEWEL REYNOSO RBT” Practice Location

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