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General NPI Number Information
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NPI Number | 1093451650
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Entity Type | Individual
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Provider Name | LUCY MKRYAN
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Gender | Female
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Dates
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Enumeration Date | 05/06/2022
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Last Update Date | 05/06/2022
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Provider Practice Location Address
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Address Line | 6350 S RILEY ST APT 204
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City | LAS VEGAS
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State | NV
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Zip | 89148-1343
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Country | US
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Telephone | 818-746-6609
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Fax |
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Provider Business Mailing Address
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Address Line | 6350 S RILEY ST APT 204
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City | LAS VEGAS
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State | NV
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Zip | 89148-1343
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Country | US
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Telephone | 818-746-6609
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Fax |
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 204909
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License Number State | NV
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