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Individual

ELIZABETH ACOSTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5604 HARMONY AVE, LAS VEGAS, NV 89107-2625
(702) 910-0300
Mailing address
5604 HARMONY AVE, LAS VEGAS, NV 89107-2625
(702) 910-0300

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
3747P1801X
Personal Care Attendant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3747P1801X
NV
Enumeration date
06/07/2019
Last updated
11/06/2020
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