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NPI Code Detail

MEDICARE: SOUTHWEST AUTISM & BEHAVIORAL SOLUTIONS

MEDICARE: SOUTHWEST AUTISM & BEHAVIORAL SOLUTIONS
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 : 1538572300
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHWEST AUTISM & BEHAVIORAL SOLUTIONS
Provider Business Mailing Address
First Line : 2700 E SUNSET RD STE 24
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-3519
Country : US
Telephone Number : 702-270-3219
Fax Number :
Provider Business Practice Location Address
First Line : 2700 E SUNSET RD STE 24
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-3519
Country : US
Telephone Number : 702-270-3219
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MS. VANESSA M FESSEWNDEN
Credential : DR
Telephone Number : 702-499-7502
Provider Enumeration Date : 06/09/2014
Last Update Date : 06/09/2014

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Directions to “SOUTHWEST AUTISM & BEHAVIORAL SOLUTIONS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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