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Individual

JAAFAH RASHAD COPPEDGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BA

Contact information

Practice address
4400 S JONES BLVD UNIT 1028, LAS VEGAS, NV 89103-3337
(702) 481-8806
Mailing address
4400 S JONES BLVD UNIT 1028, LAS VEGAS, NV 89103-3337
(702) 481-8806

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
103K00000X
Behavior Analyst
106E00000X
Assistant Behavior Analyst
106S00000X
Behavior Technician
167G00000X
Licensed Psychiatric Technician
175T00000X
Peer Specialist
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)

Other

Enumeration date
09/30/2020
Last updated
09/30/2020
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