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Individual

JOHANNA FAVELA CHAIDEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3035 S JONES BLVD STE 1, LAS VEGAS, NV 89146-6766
(702) 829-1021
Mailing address
3130 S RAINBOW BLVD STE 304, LAS VEGAS, NV 89146-6212
(702) 202-3374

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
106S00000X
Behavior Technician
Primary

Other

Enumeration date
05/30/2017
Last updated
05/24/2022
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