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NPI Code Detail

MEDICARE: CHUKA HUMPHREYS PHD

MEDICARE: CHUKA HUMPHREYS PHD
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 AnalystNV

General Provider Information

NPI Number : 1962888453
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHUKA HUMPHREYS PHD
Provider Business Mailing Address
First Line : 1735 NELLIS BLVD
Second Line : SUITE A
City : LAS VEGAS
State : NV
Zip : 89115-3673
Country : US
Telephone Number : 702-459-7500
Fax Number : 702-476-2028
Provider Business Practice Location Address
First Line : 1735 NELLIS BLVD
Second Line : SUITE A
City : LAS VEGAS
State : NV
Zip : 89115-3673
Country : US
Telephone Number : 702-459-7500
Fax Number : 702-476-2028
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2015
Last Update Date : 08/06/2015

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Directions to “ CHUKA HUMPHREYS PHD” Practice Location

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