Johnson, Gavin Lanell

Johnson, Gavin Lanell is an sole proprietor health care provider with primary practice located at 7720 Cowboy Trl , Las Vegas NV 89131-2131. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as his primary health care specialty. Johnson, Gavin Lanell can be contacted via phone (702) 510-3790.

Contact Information

Primary practice address
7720 Cowboy Trl Las Vegas NV 89131-2131
Fax:
Website:

Health care specialties

Profile Details

NPI number 1336481696
LBN Legal business name Johnson, Gavin Lanell
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 25th, 2013
Last updated Mar 25th, 2013 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336481696 NPPES
Nevada MEDICAID 1164669479

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