Individual
EPHRAIM MICHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
985 WIGWAM PKWY UNIT 1105, HENDERSON, NV 89014-6833
(267) 975-3181
Mailing address
985 WIGWAM PKWY UNIT 1105, HENDERSON, NV 89014-6833
(267) 975-3181
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
058446311
—
GA
Enumeration date
04/07/2022
Last updated
04/07/2022
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