=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891218475
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHANTAL RAINFORD BCBA, LBA, MS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/25/2017
-----------------------------------------------------
Last Update Date | 09/27/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7730 W SAHARA AVE STE 115
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89117-2753
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-660-2005
-----------------------------------------------------
Fax | 702-620-4808
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7730 W SAHARA AVE STE 115
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89117-2753
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-660-2005
-----------------------------------------------------
Fax | 702-660-4808
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106E00000X
-----------------------------------------------------
Taxonomy Name | Assistant Behavior Analyst
-----------------------------------------------------
License Number | 16-7378
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number | 1-19-34900
-----------------------------------------------------
License Number State |
-----------------------------------------------------