MEDICARE: DIAMOND HARDY

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	RBT-23-318029	NV

General Provider Information

NPI Number	:	1346077302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIAMOND HARDY

Provider Business Mailing Address
First Line	:	3800 LARKCREST ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-7069
Country	:	US
Telephone Number	:	818-510-7077
Fax Number	:

Provider Business Practice Location Address
First Line	:	8020 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7939
Country	:	US
Telephone Number	:	702-766-9840
Fax Number	:

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

Provider Enumeration Date	:	09/16/2024
Last Update Date	:	09/16/2024

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Directions to “ DIAMOND HARDY ” Practice Location

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