Healthcare Provider Details
I. General information
NPI: 1881993319
Provider Name (Legal Business Name): CESAR TIU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/23/2011
Last Update Date: 03/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8166 SANDY SLOPE CT
LAS VEGAS NV
89113-4437
US
IV. Provider business mailing address
8166 SANDY SLOPE CT
LAS VEGAS NV
89113-4437
US
V. Phone/Fax
- Phone: 318-418-0018
- Fax:
- Phone: 318-418-0018
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: