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NPI Code Detail

MEDICARE: DIANA BADEO LIBIRAN

MEDICARE: DIANA BADEO LIBIRAN
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
1247200000XOther TechnicianRBT-18-69474CA
2106S00000XBehavior TechnicianRBT-18-69474CA

General Provider Information

NPI Number : 1255804464
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA BADEO LIBIRAN
Provider Business Mailing Address
First Line : 1851 N GREEN VALLEY PKWY APT 1714
Second Line :
City : HENDERSON
State : NV
Zip : 89074-5806
Country : US
Telephone Number : 702-497-4925
Fax Number :
Provider Business Practice Location Address
First Line : 6363 S PECOS RD STE 206
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-6293
Country : US
Telephone Number : 702-850-2691
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2019
Last Update Date : 05/12/2021

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Directions to “ DIANA BADEO LIBIRAN ” Practice Location

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