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General NPI Number Information
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NPI Number | 1154956282
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Entity Type | Individual
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Provider Name | NICOLE KIRSTY QUISPE
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Gender | Female
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Dates
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Enumeration Date | 03/09/2020
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 7365 PRAIRIE FALCON RD STE 150
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City | LAS VEGAS
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State | NV
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Zip | 89128-0808
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Country | US
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Telephone | 702-766-9840
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Fax |
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Provider Business Mailing Address
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Address Line | 350 5TH AVE STE 6115
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City | NEW YORK
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State | NY
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Zip | 10118-6002
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Country | US
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Telephone | 718-215-5311
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Fax | 904-647-2295
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | LBA0966
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License Number State | NV
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