Individual
IVY CARLA BAGTAS SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5755 S RAINBOW BLVD STE 102, LAS VEGAS, NV 89118-2535
(702) 412-8578
Mailing address
5918 BELLERIVE ST, LAS VEGAS, NV 89113-0782
(702) 343-5578
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
RBT-17-29461
NV
Other
Enumeration date
01/10/2017
Last updated
06/25/2021
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