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NPI Code Detail

MEDICARE: KERLLY VAZQUEZ RBT

MEDICARE: KERLLY VAZQUEZ 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
1106S00000XBehavior Technician24-358275NV

General Provider Information

NPI Number : 1184435273
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERLLY VAZQUEZ RBT
Provider Business Mailing Address
First Line : 2711 LOVINGTON DR
Second Line :
City : HENDERSON
State : NV
Zip : 89074-3311
Country : US
Telephone Number : 702-954-2777
Fax Number :
Provider Business Practice Location Address
First Line : 2920 S RAINBOW BLVD STE 180
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-6227
Country : US
Telephone Number : 702-602-9393
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2025
Last Update Date : 12/01/2025

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Directions to “ KERLLY VAZQUEZ RBT” Practice Location

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