Individual
ELENI BAZEZEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3130 S DURANGO DR STE 400, LAS VEGAS, NV 89117-4456
(702) 319-1555
Mailing address
9947 CANYON PEAK DR, LAS VEGAS, NV 89147-8420
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-34762
NV
Other
Enumeration date
06/07/2017
Last updated
06/07/2017
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