MEDICARE: ANGELEQUE ROBLES DEGUZMAN 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
1	106S00000X	Behavior Technician	RBT-26-515558	NV

General Provider Information

NPI Number	:	1831806413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELEQUE ROBLES DEGUZMAN RBT

Provider Business Mailing Address
First Line	:	3085 E FLAMINGO RD STE AANDB
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-4308
Country	:	US
Telephone Number	:	702-605-4437
Fax Number	:	702-605-4437

Provider Business Practice Location Address
First Line	:	3085 E FLAMINGO RD STE AANDB
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-4308
Country	:	US
Telephone Number	:	702-605-4437
Fax Number	:	702-605-4437

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

Provider Enumeration Date	:	11/02/2022
Last Update Date	:	03/18/2026

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