MEDICARE: LONDON HIGHTOWER BCBA

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
1	103K00000X	Behavior Analyst	1-21-47721	NV

General Provider Information

NPI Number	:	1356856298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LONDON HIGHTOWER BCBA

Provider Business Mailing Address
First Line	:	9503 VIOLET SUNSET AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-4246
Country	:	US
Telephone Number	:	702-885-7017
Fax Number	:

Provider Business Practice Location Address
First Line	:	9503 VIOLET SUNSET AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-4246
Country	:	US
Telephone Number	:	702-885-7017
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2017
Last Update Date	:	09/04/2023

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Directions to “ LONDON HIGHTOWER BCBA” Practice Location

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