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NPI Code Detail

MEDICARE: MALISSA MCCLAIN

MEDICARE:   MALISSA  MCCLAIN
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 : 1508248428
Entity Type Code : Individual
Provider Name (Legal Business Name) : MALISSA MCCLAIN
Provider Business Mailing Address
First Line : 2330 PASEO DEL PRADO
Second Line : STE. C105
City : LAS VEGAS
State : NV
Zip : 89102-4359
Country : US
Telephone Number : 702-823-2313
Fax Number :
Provider Business Practice Location Address
First Line : 2330 PASEO DEL PRADO
Second Line : STE. C105
City : LAS VEGAS
State : NV
Zip : 89102-4359
Country : US
Telephone Number : 702-823-2313
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2015
Last Update Date : 06/27/2015

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Directions to “ MALISSA MCCLAIN ” Practice Location

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