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General NPI Number Information
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NPI Number | 1821986522
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Entity Type | Individual
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Provider Name | CHRISTIAN IPALARI RAFANAN AA
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Gender | Male
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 4040 S EASTERN AVE STE 180
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City | LAS VEGAS
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State | NV
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Zip | 89119-0809
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Country | US
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Telephone | 702-848-1696
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 S EASTERN AVE STE 240
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City | LAS VEGAS
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State | NV
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Zip | 89119-0847
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Country | US
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Telephone | 702-848-1696
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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 | BACB1306531
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License Number State | NV
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