Individual
MR. KENNETH ANGELO IACOVIELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
6130 W TROPICANA AVE STE 145, LAS VEGAS, NV 89103-4604
(702) 900-7698
Mailing address
6130 W TROPICANA AVE STE 145, LAS VEGAS, NV 89103-4604
(917) 445-7187
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-66777
NV
Other
Enumeration date
05/06/2014
Last updated
10/04/2018
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