Healthcare Provider Details

I. General information

NPI: 1063241818
Provider Name (Legal Business Name): RASIA YANKAWAY RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2024
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 E PRATER WAY STE 107
SPARKS NV
89434-8963
US

IV. Provider business mailing address

1625 E PRATER WAY STE 107
SPARKS NV
89434-8963
US

V. Phone/Fax

Practice location:
  • Phone: 775-825-4744
  • Fax:
Mailing address:
  • Phone: 775-825-4744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberRBT-4407
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: