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General NPI Number Information
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NPI Number | 1558993196
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Entity Type | Organization
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Legal Business Name | FIRST STEP WELLNESS CENTER LLC
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Dates
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Enumeration Date | 02/11/2020
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Last Update Date | 02/11/2020
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Provider Practice Location Address
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Address Line | 4650 W OAKEY BLVD APT 1054
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City | LAS VEGAS
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State | NV
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Zip | 89102-1507
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Country | US
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Telephone | 702-489-1993
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Fax |
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Provider Business Mailing Address
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Address Line | 4650 W OAKEY BLVD APT 1054
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City | LAS VEGAS
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State | NV
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Zip | 89102-1507
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Country | US
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Telephone | 702-489-1993
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NAKIA L ANTHONY
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Credential |
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Telephone | 702-489-1993
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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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