MEDICARE: KARI DELLA-ROCCO

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	103K00000X	Behavior Analyst

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1578840716	OTHER	NV	CLEAR PATH FAMILY SERVICES LLC

General Provider Information

NPI Number	:	1174983001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARI DELLA-ROCCO

Provider Business Mailing Address
First Line	:	6500 W CHARLESTON BLVD
Second Line	:	APT 113
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-9054
Country	:	US
Telephone Number	:	415-900-6027
Fax Number	:	702-396-7119

Provider Business Practice Location Address
First Line	:	5071 N RAINBOW BLVD
Second Line	:	SUITE 170
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-1606
Country	:	US
Telephone Number	:	702-373-1651
Fax Number	:	702-396-7119

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

Provider Enumeration Date	:	03/04/2016
Last Update Date	:	03/04/2016

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Directions to “ KARI DELLA-ROCCO ” Practice Location

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