Healthcare Provider Details

I. General information

NPI: 1508306218
Provider Name (Legal Business Name): ERIKA ACEVEDO RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2017
Last Update Date: 02/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 S RANCHO DR STE A
LAS VEGAS NV
89106-4873
US

IV. Provider business mailing address

2710 WINDY BREEZE CT
LAS VEGAS NV
89142-1697
US

V. Phone/Fax

Practice location:
  • Phone: 702-998-9505
  • Fax:
Mailing address:
  • Phone: 702-934-8666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberRBT-17-29906
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: