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NPI Code Detail

MEDICARE: MRS. MAKAYLA MOUANNES

MEDICARE: MRS. MAKAYLA MOUANNES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician395425NV

General Provider Information

NPI Number : 1003601261
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MAKAYLA MOUANNES
Provider Business Mailing Address
First Line : 1707 VILLAGE CENTER CIR STE 140
Second Line :
City : LAS VEGAS
State : NV
Zip : 89134-0577
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7365 PRAIRIE FALCON RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0807
Country : US
Telephone Number : 702-766-9840
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2025
Last Update Date : 04/10/2025

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Directions to “ MRS. MAKAYLA MOUANNES ” Practice Location

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