Individual
BENJAMIN ANDREW BOETTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6771 W CHARLESTON BLVD STE C, LAS VEGAS, NV 89146-9016
(702) 405-8772
(702) 405-7451
Mailing address
6509 HAMEL AVE, LAS VEGAS, NV 89122-7761
(714) 904-2065
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT3540
NV
Other
Enumeration date
07/05/2023
Last updated
07/05/2023
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