Healthcare Provider Details

I. General information

NPI: 1699646257
Provider Name (Legal Business Name): KATHLEEN LLANES RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2075 E WINDMILL LN STE 150
LAS VEGAS NV
89123-2085
US

IV. Provider business mailing address

2075 E WINDMILL LN STE 150
LAS VEGAS NV
89123-2085
US

V. Phone/Fax

Practice location:
  • Phone: 702-326-5996
  • Fax: 702-912-4662
Mailing address:
  • Phone: 702-326-5996
  • Fax: 702-912-4662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT5775
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: