Individual
KELLEY MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2715 E RUSSELL RD, LAS VEGAS, NV 89120-2426
(725) 238-4115
Mailing address
7565 REDWOOD POINT ST, LAS VEGAS, NV 89139-5434
(702) 994-5724
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT1535
NV
Other
Enumeration date
09/15/2023
Last updated
09/15/2023
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