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General NPI Number Information
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NPI Number | 1457639742
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Entity Type | Organization
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Legal Business Name | BEUG BEHAVIORAL INTERVENTION AND CONSULTING SERVICES
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Dates
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Enumeration Date | 08/03/2011
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Last Update Date | 08/03/2011
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Provider Practice Location Address
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Address Line | 7786 CERRITOS CIR
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City | SPARKS
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State | NV
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Zip | 89436-5624
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Country | US
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Telephone | 775-843-7574
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Fax | 775-448-6758
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Provider Business Mailing Address
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Address Line | 7786 CERRITOS CIR
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City | SPARKS
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State | NV
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Zip | 89436-5624
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Country | US
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Telephone | 775-843-7574
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Fax | 775-448-6758
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Authorized Official
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Title or Position | BCBA BEHAVIOR ANALYST
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Name | JACKIE MARIE BEUG
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Credential | BCBA
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Telephone | 775-843-7574
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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 | 1-09-6654
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License Number State | NV
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