Individual
PHALEN POUNDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1600 E DESERT INN RD STE 104, LAS VEGAS, NV 89169-2505
(702) 490-9009
Mailing address
1600 E DESERT INN RD STE 104, LAS VEGAS, NV 89169-2505
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/07/2016
Last updated
10/07/2016
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