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NPI Code Detail

MEDICARE: JENAYA C BUTLER

MEDICARE: JENAYA C BUTLER
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 : 1689948697
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENAYA C BUTLER
Provider Business Mailing Address
First Line : 7450 S EASTERN AVE
Second Line : 2020
City : LAS VEGAS
State : NV
Zip : 89123-1557
Country : US
Telephone Number : 313-574-8200
Fax Number :
Provider Business Practice Location Address
First Line : 7450 S EASTERN AVE
Second Line : 2020
City : LAS VEGAS
State : NV
Zip : 89123-1557
Country : US
Telephone Number : 313-574-8200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2012
Last Update Date : 03/08/2012

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Directions to “ JENAYA C BUTLER ” Practice Location

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