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NPI Code Detail

MEDICARE: REBECCA JAX

MEDICARE: REBECCA JAX
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 : 1386384915
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA JAX
Provider Business Mailing Address
First Line : 2445 DAKS LODEN CT
Second Line :
City : HENDERSON
State : NV
Zip : 89044-8767
Country : US
Telephone Number : 702-285-6325
Fax Number :
Provider Business Practice Location Address
First Line : 6767 W TROPICANA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-4754
Country : US
Telephone Number : 702-209-0370
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2022
Last Update Date : 03/31/2022

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Directions to “ REBECCA JAX ” Practice Location

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