Most Relevant Information
Provider Data
| NPI Number: | 1003680307 |
| Provider Name: | ILEANA MESA |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/08/2023 |
| Last Updated: | 11/08/2023 |
Provider Practice Location
3213 W CHARLESTON BLVD STE 101
LAS VEGAS
NV
891021991
Practice Location Phone/Fax
| Phone: | 7029873133 |
| Fax: |
Provider Mailing Location
1712 S STEEN RD
VERADALE
WA
990378053
Provider Mailing Phone/Fax
| Phone: | 7029873133 |
| Fax: |