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General NPI Number Information
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NPI Number | 1114594199
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Entity Type | Organization
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Legal Business Name | UNIQUE BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 06/08/2021
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Last Update Date | 06/08/2021
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Provider Practice Location Address
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Address Line | 3171 S JONES BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89146-6703
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Country | US
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Telephone | 702-245-2265
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Fax |
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Provider Business Mailing Address
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Address Line | 615 KINGS CENTER AVE
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89032-1159
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Country | US
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Telephone | 702-245-2265
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. TAHEESHA JOHNSON
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Credential |
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Telephone | 702-245-2265
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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 |
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License Number State |
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