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NPI Code Detail

MEDICARE: ANDREA FORSYTH M.ED, BCBA, LBA

MEDICARE: ANDREA FORSYTH M.ED, BCBA, LBA
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 Analyst1-20-44920NV

General Provider Information

NPI Number : 1962067231
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA FORSYTH M.ED, BCBA, LBA
Provider Business Mailing Address
First Line : 8275 S EASTERN AVE STE 200
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-2545
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8275 S EASTERN AVE STE 200
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-2545
Country : US
Telephone Number : 702-302-4435
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2019
Last Update Date : 03/17/2025

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