Individual
MRS. MIA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2980 S RAINBOW BLVD, SUITE 200 E, LAS VEGAS, NV 89146-6531
(702) 219-8788
(702) 889-4406
Mailing address
2980 S RAINBOW BLVD, SUITE 200 E, LAS VEGAS, NV 89146-6531
(702) 219-8788
(702) 889-4406
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902075005
—
NV
Enumeration date
11/29/2011
Last updated
11/29/2011
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