Most Relevant Information
Provider Data
| NPI Number: | 1003177973 |
| Provider Name: | KIM L GREEN |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/06/2012 |
| Last Updated: | 06/27/2019 |
Provider Practice Location
6330 MCLEOD DR STE 3
LAS VEGAS
NV
891204431
Practice Location Phone/Fax
| Phone: | 7024875480 |
| Fax: |
Provider Mailing Location
3560 W CHEYENNE AVE
SUITE 130
NORTH LAS VEGAS
NV
890328260
Provider Mailing Phone/Fax
| Phone: | 7022588023 |
| Fax: |