Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003204421 |
---|---|
Provider Name | Tiffany Clayton |
First Address | Las Vegas, NV 89149-4584 |
Second Address | Las Vegas, NV 89149-4584 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2015 |
Last Update Date | 07/01/2015 |