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General NPI Number Information
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NPI Number | 1699203810
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Entity Type | Individual
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Provider Name | ANDY SAETEURN
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Gender | Male
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Dates
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Enumeration Date | 06/01/2017
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 3900 W CHARLESTON BLVD # Y
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City | LAS VEGAS
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State | NV
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Zip | 89102-1628
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Country | US
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Telephone | 702-992-3577
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Fax | 877-214-5160
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Provider Business Mailing Address
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Address Line | 3900 W CHARLESTON BLVD # Y
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City | LAS VEGAS
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State | NV
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Zip | 89102-1628
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Country | US
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Telephone | 702-992-3577
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Fax | 877-214-5160
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-17-35988
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | LBA0342
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License Number State | NV
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