Individual
AUDRIENA NEYSA GILLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.N.A., B.S.T.
Contact information
Practice address
2700 S VALLEY VIEW BLVD APT F13, LAS VEGAS, NV 89102-0102
(702) 719-9980
Mailing address
2700 S VALLEY VIEW BLVD APT F13, LAS VEGAS, NV 89102-0102
(702) 719-9980
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
11/19/2012
Last updated
02/08/2013
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