Organization
SPECTRUM SQUAD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
QUIANA BLAKE (OWNER)
(702) 600-0904
Entity
Organization
Contact information
Practice address
1670 E FLAMINGO RD STE A, LAS VEGAS, NV 89119-5120
(702) 600-4037
(702) 710-1105
Mailing address
1670 E FLAMINGO RD STE A, LAS VEGAS, NV 89119-5120
(702) 600-4037
(702) 710-1105
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
224Z00000X
Occupational Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114475031
NPI
NV
Enumeration date
02/03/2025
Last updated
07/20/2026
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