MEDICARE: MS. AERIELLE CHAPMAN

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

General Provider Information

NPI Number	:	1982951349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AERIELLE CHAPMAN

Provider Business Mailing Address
First Line	:	8072 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2071
Country	:	US
Telephone Number	:	702-245-9883
Fax Number	:

Provider Business Practice Location Address
First Line	:	8072 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2071
Country	:	US
Telephone Number	:	702-245-9883
Fax Number	:

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

Provider Enumeration Date	:	08/04/2012
Last Update Date	:	05/16/2019

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