MEDICARE: VERLISHA AYANA FERRAND

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	:	1568984888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERLISHA AYANA FERRAND

Provider Business Mailing Address
First Line	:	1833 LUNA ALEGRE ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89115-7368
Country	:	US
Telephone Number	:	702-578-5720
Fax Number	:

Provider Business Practice Location Address
First Line	:	1833 LUNA ALEGRE ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89115-7368
Country	:	US
Telephone Number	:	702-578-5720
Fax Number	:

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

Provider Enumeration Date	:	07/07/2017
Last Update Date	:	07/21/2022

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