Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003374166 |
---|---|
Provider Name | Alissandre Casiano |
First Address | North Las Vegas, NV 89081-6884 |
Second Address | North Las Vegas, NV 89081-6884 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2019 |
Last Update Date | 07/03/2019 |