Individual
KOWAN FLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 N RAINBOW BLVD # 106-138, LAS VEGAS, NV 89107-1189
(702) 586-0880
Mailing address
2995 E SUNSET RD UNIT A129, LAS VEGAS, NV 89120-2727
(702) 308-9655
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/08/2014
Last updated
04/08/2014
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