MEDICARE: OTTO GALIANO

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

General Provider Information

NPI Number	:	1538702055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OTTO GALIANO

Provider Business Mailing Address
First Line	:	4212 EL PASADA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-3753
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2110 E FLAMINGO RD STE 205
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5192
Country	:	US
Telephone Number	:	702-620-5105
Fax Number	:

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

Provider Enumeration Date	:	10/28/2019
Last Update Date	:	10/28/2019

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Directions to “ OTTO GALIANO ” Practice Location

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