Individual
JACQUELINE LAZOOTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1416 CALLE MONTERY ST, LAS VEGAS, NV 89117-6690
(917) 716-1169
Mailing address
1416 CALLE MONTERY ST, LAS VEGAS, NV 89117-6690
(917) 716-1169
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
LBA0244
NV
Other
Enumeration date
08/30/2019
Last updated
09/14/2022
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