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General NPI Number Information
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NPI Number | 1518261726
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Entity Type | Individual
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Provider Name | VERNON STEPHEN BOARDLEY
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Gender | Male
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Dates
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Enumeration Date | 01/03/2011
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Last Update Date | 01/03/2011
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Provider Practice Location Address
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Address Line | 2026 SILVERTON DR
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City | HENDERSON
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State | NV
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Zip | 89074-1550
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Country | US
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Telephone | 702-617-3466
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Fax |
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Provider Business Mailing Address
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Address Line | 3753 PREFONTAINE RD
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City | LAS VEGAS
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State | NV
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Zip | 89115-1572
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Country | US
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Telephone | 702-503-5070
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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