Individual
KELLIE QISHON CANGAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
3950 LAS VEGAS BLVD N # A2, LAS VEGAS, NV 89115-0598
(702) 547-6971
(702) 547-6948
Mailing address
1060 WIGWAM PKWY, HENDERSON, NV 89074-8162
(702) 547-6971
(702) 547-6948
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-22-
BACB
NV
Enumeration date
11/22/2022
Last updated
11/22/2022
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