Individual
IBN MILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7560 W SAHARA AVE STE 107, LAS VEGAS, NV 89117-2745
(702) 476-2633
(702) 979-1028
Mailing address
5575 SIMMONS ST STE 1-491, NORTH LAS VEGAS, NV 89031-9009
(702) 476-2633
(702) 979-1028
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-22-200437
NV
106S00000X
Behavior Technician
Primary
RBT2497
NV
Other
Enumeration date
01/28/2022
Last updated
01/28/2022
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