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NPI Code Detail

MEDICARE: ALEXANDRA TAYLOR KANTANAVICIUS BCBA, LBA

MEDICARE: ALEXANDRA TAYLOR KANTANAVICIUS BCBA, LBA
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 TechnicianRBT-20-112543NV
2103K00000XBehavior Analyst1-25-81410NV

General Provider Information

NPI Number : 1265948103
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA TAYLOR KANTANAVICIUS BCBA, LBA
Provider Business Mailing Address
First Line : 10947 CAMDEN BAY ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89179-1641
Country : US
Telephone Number : 702-606-0036
Fax Number :
Provider Business Practice Location Address
First Line : 1707 VILLAGE CENTER CIR STE 140
Second Line :
City : LAS VEGAS
State : NV
Zip : 89134-0577
Country : US
Telephone Number : 702-766-9840
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2017
Last Update Date : 06/19/2025

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