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General NPI Number Information
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NPI Number | 1407644362
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Entity Type | Individual
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Provider Name | HAILEY LYNN ROSENTHAL
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Gender | Female
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Dates
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Enumeration Date | 04/29/2025
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 5765 S RAINBOW BLVD STE 101-102
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City | LAS VEGAS
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State | NV
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Zip | 89118-2536
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Country | US
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Telephone | 702-412-8578
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Fax |
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Provider Business Mailing Address
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Address Line | 5464 STACKED CHIPS RD UNIT 103
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City | LAS VEGAS
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State | NV
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Zip | 89122-2664
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Country | US
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Telephone | 702-945-6204
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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