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General NPI Number Information
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NPI Number | 1083298418
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Entity Type | Individual
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Provider Name | KAILEE SANDBERG
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Gender | Female
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Dates
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Enumeration Date | 05/11/2021
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Last Update Date | 04/13/2024
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Provider Practice Location Address
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Address Line | 8020 W SAHARA AVE STE 160
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City | LAS VEGAS
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State | NV
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Zip | 89117-7917
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Country | US
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Telephone | 702-595-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 2821 W HORIZON RIDGE PKWY STE 130
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City | HENDERSON
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State | NV
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Zip | 89052-4429
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Country | US
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Telephone | 702-840-1182
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Fax | 702-436-2593
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-21-157538
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-22-59746
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License Number State | NV
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