Healthcare Provider Details

I. General information

NPI: 1518820208
Provider Name (Legal Business Name): IM THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9750 W SKYE CANYON PARK DR STE 160-283
LAS VEGAS NV
89166-6623
US

IV. Provider business mailing address

9750 W SKYE CANYON PARK DR STE 160-283
LAS VEGAS NV
89166-6623
US

V. Phone/Fax

Practice location:
  • Phone: 702-763-6664
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: YUKI CANDY M. N. LEE
Title or Position: BCBA
Credential: BCBA
Phone: 702-763-6664