Individual
PREMITIVA ALEXANDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2110 E FLAMINGO RD # 150, LAS VEGAS, NV 89119-5190
(910) 261-7627
Mailing address
2110 E FLAMINGO RD # 150, LAS VEGAS, NV 89119-5190
(910) 261-7627
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
16-24407
NV
Other
Enumeration date
01/11/2017
Last updated
01/12/2017
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