Individual
MIKE WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4430 VERDUGO ST, LAS VEGAS, NV 89147-4777
(702) 321-8493
Mailing address
4430 VERDUGO ST, LAS VEGAS, NV 89147-4777
(702) 321-8493
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/06/2011
Last updated
07/06/2011
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