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NPI Code Detail

MEDICARE: DAVID VILLELLA

MEDICARE: DAVID VILLELLA
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 : 1700273489
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID VILLELLA
Provider Business Mailing Address
First Line : 6887 TAMARUS ST
Second Line : #202
City : LAS VEGAS
State : NV
Zip : 89119-0459
Country : US
Telephone Number : 917-449-0075
Fax Number :
Provider Business Practice Location Address
First Line : 6887 TAMARUS ST
Second Line : #202
City : LAS VEGAS
State : NV
Zip : 89119-0459
Country : US
Telephone Number : 917-449-0075
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2015
Last Update Date : 04/21/2015

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Directions to “ DAVID VILLELLA ” Practice Location

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