Healthcare Provider Details
I. General information
NPI: 1003374166
Provider Name (Legal Business Name): ALISSANDRE CASIANO MS, BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/07/2019
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
555 N MARYLAND PKWY
LAS VEGAS NV
89101-3133
US
IV. Provider business mailing address
5353 BRAZELTON ST
NORTH LAS VEGAS NV
89081-2459
US
V. Phone/Fax
- Phone: 702-789-7282
- Fax:
- Phone: 210-204-4585
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | LBA0761 |
| License Number State | NV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: