Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106S00000X | Behavior Technician | ||
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1316537624 |
---|---|
Provider Name | Yentl Serrano |
First Address | North Las Vegas, NV 89031-3891 |
Second Address | North Las Vegas, NV 89031-3891 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2021 |
Last Update Date | 10/03/2021 |