Individual
MR. EUGENE DWAYNE LIVINGSTON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
731 MALL RING CIR STE 215, HENDERSON, NV 89014-6691
(702) 547-6971
Mailing address
3108 COUNTRY DANCER AVE, NORTH LAS VEGAS, NV 89081
(310) 904-9711
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT
REGISTERED BEHAVIOR TECHNICIAN
NV
Enumeration date
08/01/2017
Last updated
08/01/2017
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