Johnshell Holliday
Behavior Technician in Las Vegas, NV. Individual provider (NPI-1).
NPI number1669916482
StatusActive
Last updated in NPPESMay 5, 2017
Details
- NPI
- 1669916482
- Entity type
- Individual (NPI-1)
- Name
- Johnshell Holliday
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 13, 2016
- Last updated
- May 5, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | 17-30650 | NV | Yes |
Practice location
6897 W Charleston BlvdLas Vegas, NV 89117-1640
Phone 614-783-4936
Mailing address
6897 W Charleston BlvdLas Vegas, NV 89117-1640
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