Healthcare Provider Details

I. General information

NPI: 1194509703
Provider Name (Legal Business Name): AUBRYE BUHECKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2023
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3515 W CHARLESTON BLVD
LAS VEGAS NV
89102-1839
US

IV. Provider business mailing address

3157 N RAINBOW BLVD STE K7-247
LAS VEGAS NV
89108-4578
US

V. Phone/Fax

Practice location:
  • Phone: 702-900-7698
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT4549
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-318102
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: