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NPI Code Detail

MEDICARE: ANISHA RICHARDS

MEDICARE:   ANISHA  RICHARDS
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 Technician

General Provider Information

NPI Number : 1164953964
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANISHA RICHARDS
Provider Business Mailing Address
First Line : 2129 TRAVIS ST
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-4013
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2129 TRAVIS ST
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-4013
Country : US
Telephone Number : 775-507-0822
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2017
Last Update Date : 03/23/2017

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Directions to “ ANISHA RICHARDS ” Practice Location

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