John Emil Zetterholm

Individual provider Active NPI Behavior Technician · Las Vegas, NV

NPI 1073474151 · NPPES record last updated Nov 19, 2025

Key facts

NPI
1073474151
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
BACB1414442 (NV)
Practice address
1091 S Cimarron Rd Ste A5
Las Vegas, NV 89145-2445
Phone
(702) 992-7908
NPI assigned
Nov 19, 2025
Sex
Male
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

State licenses

LicenseStateTypeSpecialty
BACB1414442NVMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician
Group: 193400000X SINGLE SPECIALTY GROUP
106S00000X BACB1414442 NV Yes

Addresses

Primary practice location

1091 S Cimarron Rd Ste A5
Las Vegas, NV 89145-2445

Mailing address

1091 S Cimarron Rd Ste A5
Las Vegas, NV 89145-2445
Phone (702) 992-7908

Other providers in Las Vegas, NV

All providers in Las Vegas, NV · Behavior Technician in Nevada

Sources for this page

Verify at the official NPI Registry.