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NPI Code Detail

MEDICARE: ALLEA WALTERS BCBA

MEDICARE: ALLEA WALTERS 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
1106S00000XBehavior TechnicianRBT-20-142580NV
2103K00000XBehavior Analyst1-22-62177NV

General Provider Information

NPI Number : 1407451933
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLEA WALTERS BCBA
Provider Business Mailing Address
First Line : 6471 AMERICAN EAGLE AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89131-3252
Country : US
Telephone Number : 702-339-5565
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 : 702-339-5565
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2020
Last Update Date : 11/16/2022

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Directions to “ ALLEA WALTERS BCBA” Practice Location

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