Healthcare Provider Details

I. General information

NPI: 1104747963
Provider Name (Legal Business Name): EMILY NICOLE GARAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7365 PRAIRIE FALCON RD STE 150
LAS VEGAS NV
89128-0808
US

IV. Provider business mailing address

5850 SKY POINTE DR APT 1144
LAS VEGAS NV
89130-4963
US

V. Phone/Fax

Practice location:
  • Phone: 702-766-9840
  • Fax: 702-766-9840
Mailing address:
  • Phone: 702-280-2802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number24398116
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: