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General NPI Number Information
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NPI Number | 1558712141
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Entity Type | Individual
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Provider Name | CHRISTINA EPIPHANY GRANT RBT
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Gender | Female
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Dates
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Enumeration Date | 06/25/2016
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Last Update Date | 06/25/2016
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Provider Practice Location Address
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Address Line | 731 MALL RING CIR STE 215
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City | HENDERSON
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State | NV
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Zip | 89014-6691
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Country | US
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Telephone | 702-300-6818
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Fax |
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Provider Business Mailing Address
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Address Line | 2362 N GREEN VALLEY PKWY BLDG S APT 319
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City | HENDERSON
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State | NV
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Zip | 89014-3661
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Country | US
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Telephone | 702-542-5953
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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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