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General NPI Number Information
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NPI Number | 1578277042
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Entity Type | Organization
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Legal Business Name | NEVADA ABA THERAPY PROF LLC
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Dates
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Enumeration Date | 01/10/2023
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Last Update Date | 01/10/2023
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Provider Practice Location Address
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Address Line | 9024 MISTY LEAF AVE
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City | LAS VEGAS
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State | NV
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Zip | 89148-5147
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Country | US
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Telephone | 949-413-3756
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Fax |
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Provider Business Mailing Address
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Address Line | 9024 MISTY LEAF AVE
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City | LAS VEGAS
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State | NV
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Zip | 89148-5147
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Country | US
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Telephone | 949-413-3756
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARIAM NAWABI
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Credential | MA, LBA, BCBA
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Telephone | 949-413-3756
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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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