Individual
ALVARO CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5409 GOLDBRUSH ST, LAS VEGAS, NV 89130-1678
(702) 287-9127
(702) 570-5200
Mailing address
5409 GOLDBRUSH ST, LAS VEGAS, NV 89130-1678
(702) 287-9127
(702) 570-5200
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1604211634
MEDICAID
NV
Enumeration date
10/21/2016
Last updated
10/21/2016
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