Innocent Akhidenor

Individual provider Active NPI Behavior Analyst · North Las Vegas, NV

NPI 1114459740 · NPPES record last updated Apr 2, 2017

Key facts

NPI
1114459740
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
Practice address
2270 Losee Rd
North Las Vegas, NV 89030-4109
Phone
(702) 399-1070
NPI assigned
Apr 2, 2017
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Yes

Addresses

Primary practice location

2270 Losee Rd
North Las Vegas, NV 89030-4109

Mailing address

2270 Losee Rd
North Las Vegas, NV 89030-4109

Other providers in North Las Vegas, NV

All providers in North Las Vegas, NV · Behavior Analyst in Nevada

Sources for this page

Verify at the official NPI Registry.