Individual
JUAN MANUEL JUAREZ JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
480 GALLETTI WAY, SPARKS, NV 89431-5564
(530) 208-7270
Mailing address
480 GALLETTI WAY # 8, SPARKS, NV 89431-5564
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101Y00000X
ATC
NV
01
—
225C00000X
ATC
NV
Enumeration date
12/18/2018
Last updated
12/18/2018
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