Individual
OMAR BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8430 W LAKE MEAD BLVD # 113, LAS VEGAS, NV 89128-7672
(702) 576-9892
Mailing address
8430 W LAKE MEAD BLVD # 113, LAS VEGAS, NV 89128-7672
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000000
—
NV
Enumeration date
06/27/2017
Last updated
06/27/2017
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