Individual
JONATHAN WEATHERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9512 CANYONLAND CT, LAS VEGAS, NV 89147-8339
(702) 884-6991
Mailing address
9512 CANYONLAND CT, LAS VEGAS, NV 89147-8339
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/14/2018
Last updated
06/14/2018
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