Individual
JADSU KALID JAVIER I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4480 MICHIGAN AVE, LAS VEGAS, NV 89104-5517
(702) 619-0782
Mailing address
4480 MICHIGAN AVE, LAS VEGAS, NV 89104-5517
(702) 619-0782
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
15038
NV
Other
Enumeration date
12/02/2016
Last updated
12/02/2016
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