MEDICARE: MARIAN IRAN TAPIA 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
1	103K00000X	Behavior Analyst	RBT-16-22798	NV
2	106S00000X	Behavior Technician	26-22798
3	106E00000X	Assistant Behavior Analyst	RBT-16-22798	NV

General Provider Information

NPI Number	:	1265987515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIAN IRAN TAPIA RBT

Provider Business Mailing Address
First Line	:	8704 DIAMOND CREEK CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-0323
Country	:	US
Telephone Number	:	818-406-2891
Fax Number	:	888-865-9497

Provider Business Practice Location Address
First Line	:	8704 DIAMOND CREEK CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-0323
Country	:	US
Telephone Number	:	818-406-2891
Fax Number	:	888-865-9498

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

Provider Enumeration Date	:	08/16/2016
Last Update Date	:	08/09/2022

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