Jacquelyn Abah
Individual provider Active NPI Behavior Analyst · Las Vegas, NV
NPI 1053661868 · NPPES record last updated Sep 19, 2012
Key facts
- NPI
- 1053661868
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- Practice address
- 6172 Bridgeport Hills Ave
Las Vegas, NV 89139-6837 - Phone
- (702) 601-3767
- NPI assigned
- Sep 19, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Yes |
Addresses
Primary practice location
6172 Bridgeport Hills Ave
Las Vegas, NV 89139-6837
Mailing address
6172 Bridgeport Hills Ave
Las Vegas, NV 89139-6837
Phone (702) 601-3767
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.