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NPI Code Detail

MEDICARE: CORINA AVALOS

MEDICARE: CORINA AVALOS
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
2106S00000XBehavior TechnicianRBT-18-66289NV
3106S00000XBehavior TechnicianRBT0400NV

General Provider Information

NPI Number : 1568954972
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORINA AVALOS
Provider Business Mailing Address
First Line : 9568 KNOTWEED AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-5521
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7560 W SAHARA AVE STE 107
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-2745
Country : US
Telephone Number : 702-476-2633
Fax Number : 702-979-1028
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2018
Last Update Date : 08/16/2022

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Directions to “ CORINA AVALOS ” Practice Location

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