Healthcare Provider Details

I. General information

NPI: 1154245371
Provider Name (Legal Business Name): ELENA BEATRIZ GUERRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1063 SPOTTED SADDLE ST
HENDERSON NV
89015-5686
US

IV. Provider business mailing address

1063 SPOTTED SADDLE ST
HENDERSON NV
89015-5686
US

V. Phone/Fax

Practice location:
  • Phone: 702-234-0019
  • Fax:
Mailing address:
  • Phone: 702-234-0019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: