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General NPI Number Information
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NPI Number | 1528574365
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Entity Type | Individual
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Provider Name | CIERRA PATRICIA WALLING BCBA
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Gender | Female
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Dates
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Enumeration Date | 12/15/2017
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Last Update Date | 07/28/2023
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Provider Practice Location Address
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Address Line | 3037 E WARM SPRINGS RD STE 200-13
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City | LAS VEGAS
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State | NV
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Zip | 89120-3758
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Country | US
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Telephone | 702-900-7179
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 N GREEN VALLEY PKWY # 440-604
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City | HENDERSON
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State | NV
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Zip | 89074-6170
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Country | US
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Telephone | 702-900-7179
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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 | BEH-000527
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License Number State | AZ
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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 | 60771903
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | LBA0528
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License Number State | NV
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