MEDICARE: RODSHIEKKA CHESTER

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

General Provider Information

NPI Number	:	1467837351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RODSHIEKKA CHESTER

Provider Business Mailing Address
First Line	:	1240 W OWENS AVE STE 3
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-2452
Country	:	US
Telephone Number	:	702-483-3100
Fax Number	:

Provider Business Practice Location Address
First Line	:	6008 RIDGECARN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-1373
Country	:	US
Telephone Number	:	702-910-6415
Fax Number	:

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

Provider Enumeration Date	:	07/21/2015
Last Update Date	:	07/20/2020

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Directions to “ RODSHIEKKA CHESTER ” Practice Location

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