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NPI Code Detail

MEDICARE: DARRELL BERNARD THOMAS

MEDICARE: DARRELL BERNARD THOMAS
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

General Provider Information

NPI Number : 1285162420
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARRELL BERNARD THOMAS
Provider Business Mailing Address
First Line : 1288 MILLER AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-2210
Country : US
Telephone Number : 702-556-4277
Fax Number :
Provider Business Practice Location Address
First Line : 1288 MILLER AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-2210
Country : US
Telephone Number : 702-556-4277
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2017
Last Update Date : 07/21/2022

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Directions to “ DARRELL BERNARD THOMAS ” Practice Location

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