MEDICARE: LAMIJA REDZIC

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	106S00000X	Behavior Technician	RBT-16-20308	NV

General Provider Information

NPI Number	:	1780032961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAMIJA REDZIC

Provider Business Mailing Address
First Line	:	303 WINDMILL CROFT DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5290
Country	:	US
Telephone Number	:	702-425-0069
Fax Number	:

Provider Business Practice Location Address
First Line	:	7390 W SAHARA AVE STE 260
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2765
Country	:	US
Telephone Number	:	702-900-4320
Fax Number	:

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

Provider Enumeration Date	:	05/30/2016
Last Update Date	:	04/12/2019

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Directions to “ LAMIJA REDZIC ” Practice Location

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