Individual
KEZIAH INNISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7365 PRAIRIE FALCON RD STE 150, LAS VEGAS, NV 89128-0808
(702) 766-9840
Mailing address
12780 BATTISTA LN, HENDERSON, NV 89044-1055
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT4143
NV
Other
Enumeration date
04/10/2024
Last updated
04/10/2024
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