Individual
MICAH ZELLE DENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3435 W CRAIG RD STE B, NORTH LAS VEGAS, NV 89032-5116
(702) 207-4458
Mailing address
3435 W CRAIG RD STE B, NORTH LAS VEGAS, NV 89032-5116
(702) 207-4458
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
821787155
—
NV
Enumeration date
09/16/2019
Last updated
09/16/2019
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