MEDICARE: IM THERAPY LLC

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	103K00000X	Behavior Analyst

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1-22-58826	OTHER		BACB

General Provider Information

NPI Number	:	1518820208
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IM THERAPY LLC

Provider Business Mailing Address
First Line	:	9750 W SKYE CANYON PARK DR STE 160-283
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89166-6623
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9750 W SKYE CANYON PARK DR STE 160-283
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89166-6623
Country	:	US
Telephone Number	:	702-763-6664
Fax Number	:

Authorized Official
Title or Position	:	BCBA
Name	:	YUKI CANDY M. N. LEE
Credential	:	BCBA
Telephone Number	:	702-763-6664

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/10/2025

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Directions to “IM THERAPY LLC ” Practice Location

Language	Start Address	Practice Location

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