Healthcare Provider Details

I. General information

NPI: 1700708328
Provider Name (Legal Business Name): BEHAVIOR BUILT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 HEATHER LN
FERNLEY NV
89408-9779
US

IV. Provider business mailing address

222 HEATHER LN
FERNLEY NV
89408-9779
US

V. Phone/Fax

Practice location:
  • Phone: 951-285-4248
  • Fax:
Mailing address:
  • Phone: 951-285-4248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: KAYLA NICHOLE CLARK
Title or Position: OWNER
Credential: BCBA
Phone: 951-285-4248