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NPI Code Detail

MEDICARE: JADE PRYOR RBT

MEDICARE: JADE PRYOR 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
1103K00000XBehavior AnalystRBT15332614493NV
2106S00000XBehavior TechnicianRBT-15-09936NV

General Provider Information

NPI Number : 1487009239
Entity Type Code : Individual
Provider Name (Legal Business Name) : JADE PRYOR RBT
Provider Business Mailing Address
First Line : 7261 W CHARLESTON BLVD STE 101
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-1679
Country : US
Telephone Number : 725-251-2059
Fax Number : 702-222-0212
Provider Business Practice Location Address
First Line : 7261 W CHARLESTON BLVD STE 101
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-1679
Country : US
Telephone Number : 725-251-2059
Fax Number : 702-222-0212
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2016
Last Update Date : 09/15/2021

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Directions to “ JADE PRYOR RBT” Practice Location

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