Individual
DOMINIQUE BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3101 W CHARLESTON BLVD, LAS VEGAS, NV 89102-1931
(702) 831-6670
Mailing address
3101 W CHARLESTON BLVD, LAS VEGAS, NV 89102-1931
(808) 542-1204
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-199223
NV
Other
Enumeration date
01/13/2022
Last updated
01/13/2022
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