Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003353905 |
---|---|
Provider Name | Valeria Virginia Carreto |
First Address | Las Vegas, NV 89156-8015 |
Second Address | Las Vegas, NV 89142-1123 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2017 |
Last Update Date | 30/01/2017 |