Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003105693 |
---|---|
Provider Name | Vernon Sanders JR. |
First Address | North Las Vegas, NV 89081-2676 |
Second Address | North Las Vegas, NV 89081-2676 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2011 |
Last Update Date | 04/04/2011 |