| NPI | 1134542152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAIELLA CLARK-STEPHENS Owner 702-708-1275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2014-01-27 |
| Last Update Date | 2014-01-27 |