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NPI Code Detail

MEDICARE: MIA DUVERNEAU-MICHEL

MEDICARE: MIA DUVERNEAU-MICHEL
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 TechnicianRBT-21-160450

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RBT1634OTHERNVBOARD OF APPLIED BEHAVIOR ANALYSIS
2RBT-21-160450OTHERBEHAVIOR ANALYST CERTIFICATION BOARD

General Provider Information

NPI Number : 1073256467
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIA DUVERNEAU-MICHEL
Provider Business Mailing Address
First Line : 1127 S RANCHO DR STE 170
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-2216
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1127 S RANCHO DR STE 170
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-2216
Country : US
Telephone Number : 888-611-0870
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2022
Last Update Date : 04/14/2022

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Directions to “ MIA DUVERNEAU-MICHEL ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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