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General NPI Number Information
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NPI Number | 1487009239
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Entity Type | Individual
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Provider Name | JADE PRYOR RBT
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Gender | Female
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Dates
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Enumeration Date | 04/29/2016
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Last Update Date | 09/15/2021
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Provider Practice Location Address
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Address Line | 7261 W CHARLESTON BLVD STE 101
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City | LAS VEGAS
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State | NV
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Zip | 89117-1679
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Country | US
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Telephone | 725-251-2059
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Fax | 702-222-0212
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Provider Business Mailing Address
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Address Line | 7261 W CHARLESTON BLVD STE 101
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City | LAS VEGAS
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State | NV
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Zip | 89117-1679
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Country | US
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Telephone | 725-251-2059
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Fax | 702-222-0212
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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 | RBT15332614493
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-15-09936
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License Number State | NV
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