Individual
KYLE ROBERT BRADSHAW DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 LOS ALTOS PKWY STE 109, SPARKS, NV 89436-7754
(775) 996-3890
Mailing address
15130 WESTERN SPRINGS DR, RENO, NV 89521-8313
(775) 351-3677
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/28/2020
Last updated
08/28/2020
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