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NPI Code Detail

MEDICARE: KE-YARA GREENE RBT

MEDICARE: KE-YARA GREENE 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
1106S00000XBehavior TechnicianRBT-25-491812NV

General Provider Information

NPI Number : 1356209746
Entity Type Code : Individual
Provider Name (Legal Business Name) : KE-YARA GREENE RBT
Provider Business Mailing Address
First Line : 9041 S PECOS RD STE 3900
Second Line :
City : HENDERSON
State : NV
Zip : 89074-6601
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9041 S PECOS RD STE 3900
Second Line :
City : HENDERSON
State : NV
Zip : 89074-6601
Country : US
Telephone Number : 702-680-1526
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2026
Last Update Date : 01/13/2026

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Directions to “ KE-YARA GREENE RBT” Practice Location

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