Individual
SHANTA NEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9445 CORAL BERRY ST, LAS VEGAS, NV 89123-5832
(702) 544-8742
Mailing address
9445 CORAL BERRY ST, LAS VEGAS, NV 89123-5832
(702) 544-8742
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
06/03/2019
Last updated
06/03/2019
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