Individual
SOPHIA BIANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
5755 S RAINBOW BLVD STE 102, LAS VEGAS, NV 89118-2535
(321) 443-9191
Mailing address
5755 S RAINBOW BLVD STE 102, LAS VEGAS, NV 89118-2535
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902119696
—
NV
Enumeration date
06/29/2017
Last updated
05/26/2020
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