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NPI Code Detail

MEDICARE: TAYLOR ZUCCO-KIMBALL RBT

MEDICARE: TAYLOR ZUCCO-KIMBALL RBT
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
1106S00000XBehavior TechnicianRBT0362NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RBT-16-20158OTHERRBT CREDENTIAL

General Provider Information

NPI Number : 1750931796
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR ZUCCO-KIMBALL RBT
Provider Business Mailing Address
First Line : 2075 E WINDMILL LN STE 150
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-2085
Country : US
Telephone Number : 702-326-5996
Fax Number :
Provider Business Practice Location Address
First Line : 2075 E WINDMILL LN STE 150
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-2085
Country : US
Telephone Number : 702-326-5996
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2019
Last Update Date : 09/11/2019

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Directions to “ TAYLOR ZUCCO-KIMBALL RBT” Practice Location

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