Individual
JOHNSHELL HOLLIDAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6897 W CHARLESTON BLVD, LAS VEGAS, NV 89117-1640
(614) 783-4936
Mailing address
6897 W CHARLESTON BLVD, LAS VEGAS, NV 89117-1640
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
17-30650
NV
Other
Enumeration date
12/13/2016
Last updated
05/05/2017
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