Individual
BROOKLYN WANGSGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3130 S DURANGO DR STE 425, LAS VEGAS, NV 89117-4455
(702) 972-6823
Mailing address
4620 PONY EXPRESS ST, NORTH LAS VEGAS, NV 89031-0115
(801) 505-3783
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
04/10/2019
Last updated
05/30/2019
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