Individual
MY'CKAEL ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1771 E FLAMINGO RD, LAS VEGAS, NV 89119-5155
(702) 560-2192
Mailing address
6180 STONE HOLLOW AVE, LAS VEGAS, NV 89156-4797
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/04/2022
Last updated
03/04/2022
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