Individual
KYLE DOUGLAS SEBASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7125 GRAND MONTECITO PKWY STE 130, LAS VEGAS, NV 89149-0261
(702) 396-0101
Mailing address
3749 LA JUNTA DR, LAS VEGAS, NV 89120-1235
(702) 487-1604
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/19/2019
Last updated
10/19/2019
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