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General NPI Number Information
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NPI Number | 1649046020
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Entity Type | Organization
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Legal Business Name | VICTORIA MANON BEHAVIOR SOLUTIONS LLC
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Dates
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Enumeration Date | 11/28/2023
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 5325 S FORT APACHE RD STE D-186
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City | LAS VEGAS
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State | NV
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Zip | 89148-4665
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Country | US
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Telephone | 702-350-1231
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Fax | 702-637-0779
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Provider Business Mailing Address
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Address Line | 5325 S FORT APACHE RD STE D186
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City | LAS VEGAS
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State | NV
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Zip | 89148-4665
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JACQUELINE LAZOOTIN
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Credential | BCBA
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Telephone | 917-716-1169
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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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