Healthcare Provider Details

I. General information

NPI: 1134598824
Provider Name (Legal Business Name): QUADRILLYN PRETLOW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2015
Last Update Date: 12/30/2020
Certification Date: 12/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 N GREEN VALLEY PKWY STE 9A
HENDERSON NV
89074-5991
US

IV. Provider business mailing address

3317 CONTERRA PARK AVE
N LAS VEGAS NV
89081-6537
US

V. Phone/Fax

Practice location:
  • Phone: 702-301-5695
  • Fax:
Mailing address:
  • Phone: 702-526-4844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: