Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106E00000X | Assistant Behavior Analyst | RN78359 | NV |
NPI | 1023544301 |
---|---|
Provider Name | Kellie Marsh |
First Address | Las Vegas, NV 89128-7282 |
Second Address | Las Vegas, NV 89128-7282 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2017 |
Last Update Date | 08/08/2017 |