MEDICARE: DANA PADELFORD BCBA

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	1-17-27442	FL

General Provider Information

NPI Number	:	1912361684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA PADELFORD BCBA

Provider Business Mailing Address
First Line	:	7380 UMBERTO ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-2679
Country	:	US
Telephone Number	:	941-504-1625
Fax Number	:

Provider Business Practice Location Address
First Line	:	7380 UMBERTO ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-2679
Country	:	US
Telephone Number	:	941-504-1625
Fax Number	:

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

Provider Enumeration Date	:	04/08/2016
Last Update Date	:	12/14/2023

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