Individual
BERTHA JEANIE BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4435 MATINEE AVE, N LAS VEGAS, NV 89031-0417
(702) 696-8091
Mailing address
4435 MATINEE AVE, N LAS VEGAS, NV 89031
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
103T00000X
Psychologist
—
—
Other
Enumeration date
05/09/2011
Last updated
05/09/2011
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