MEDICARE: CARLY PARNELL

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1336024207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLY PARNELL

Provider Business Mailing Address
First Line	:	6200 N DURANGO DR STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-3939
Country	:	US
Telephone Number	:	702-577-2606
Fax Number	:	702-710-6023

Provider Business Practice Location Address
First Line	:	3630 N RANCHO DR STE 107
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-3111
Country	:	US
Telephone Number	:	702-577-2606
Fax Number	:	702-710-6023

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

Provider Enumeration Date	:	08/08/2025
Last Update Date	:	08/08/2025

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Directions to “ CARLY PARNELL ” Practice Location

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