Individual
EDY AGEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 W VAN BUREN AVE, LAS VEGAS, NV 89106-3043
(808) 780-1218
Mailing address
700 W VAN BUREN AVE, LAS VEGAS, NV 89106-3043
(808) 780-1218
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
Primary
—
—
171W00000X
Contractor
—
—
372600000X
Adult Companion
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
12/01/2018
Last updated
07/18/2019
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