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NPI Code Detail

MEDICARE: EMILY YVETTE BRACAMONTES

MEDICARE: EMILY YVETTE BRACAMONTES
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 : 1174238083
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY YVETTE BRACAMONTES
Provider Business Mailing Address
First Line : 5980 S DURANGO DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-1779
Country : US
Telephone Number : 888-505-1637
Fax Number :
Provider Business Practice Location Address
First Line : 5980 S DURANGO DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-1779
Country : US
Telephone Number : 888-505-1637
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2023
Last Update Date : 01/16/2023

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Directions to “ EMILY YVETTE BRACAMONTES ” Practice Location

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