MEDICARE: RYAN SMITH

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	106S00000X	Behavior Technician	RBT6427	NV

General Provider Information

NPI Number	:	1730019530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN SMITH

Provider Business Mailing Address
First Line	:	6873 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1600
Country	:	US
Telephone Number	:	725-780-9785
Fax Number	:

Provider Business Practice Location Address
First Line	:	6873 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1600
Country	:	US
Telephone Number	:	626-833-8424
Fax Number	:

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

Provider Enumeration Date	:	05/22/2026
Last Update Date	:	05/22/2026

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Directions to “ RYAN SMITH ” Practice Location

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