Individual
MAKAELA RENEE WILFONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6200 N DURANGO DR STE 110, LAS VEGAS, NV 89149-3939
(702) 577-2606
Mailing address
6200 N DURANGO DR STE 110, LAS VEGAS, NV 89149-3939
(702) 577-2606
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-226130
—
106S00000X
Behavior Technician
RBT2806
NV
Other
Enumeration date
07/22/2022
Last updated
12/28/2023
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