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NPI Code Detail

MEDICARE: MS. ROSELLA BEVERLY

MEDICARE: MS. ROSELLA BEVERLY
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
1103K00000XBehavior Analyst

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215210646
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ROSELLA BEVERLY
Provider Business Mailing Address
First Line : 6330 MCLEOD DR. STE#3
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-4431
Country : US
Telephone Number : 702-754-3484
Fax Number : 702-629-7952
Provider Business Practice Location Address
First Line : 6330 MCLEOD DR STE 3
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-4431
Country : US
Telephone Number : 702-754-3484
Fax Number : 702-629-7952
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2011
Last Update Date : 02/04/2015

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Directions to “ MS. ROSELLA BEVERLY ” Practice Location

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