Healthcare Provider Details

I. General information

NPI: 1497244834
Provider Name (Legal Business Name): NICOLE TOMAR BURNS RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2018
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9089 S PECOS RD STE 3400
HENDERSON NV
89074-7184
US

IV. Provider business mailing address

9089 S PECOS RD STE 3400
HENDERSON NV
89074-7184
US

V. Phone/Fax

Practice location:
  • Phone: 702-867-5810
  • Fax: 702-867-5811
Mailing address:
  • Phone: 702-867-5810
  • Fax: 702-867-5811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-18-54578
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: