MEDICARE: KAYDRE THOMPSON RBT

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
1	106S00000X	Behavior Technician	RBT-24-349983	AZ

General Provider Information

NPI Number	:	1053037101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYDRE THOMPSON RBT

Provider Business Mailing Address
First Line	:	3650 N RANCHO DR STE 108
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-3151
Country	:	US
Telephone Number	:	702-990-0326
Fax Number	:

Provider Business Practice Location Address
First Line	:	3650 N RANCHO DR STE 108
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-3151
Country	:	US
Telephone Number	:	702-990-0326
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2022
Last Update Date	:	02/25/2026

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Directions to “ KAYDRE THOMPSON RBT” Practice Location

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