Provider Demographics
NPI:1033562004
Name:MAJOR, ROBERT
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:MAJOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S RAINBOW BLVD
Mailing Address - Street 2:SUIT#1
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-5362
Mailing Address - Country:US
Mailing Address - Phone:702-778-8922
Mailing Address - Fax:702-778-8789
Practice Address - Street 1:101 S RAINBOW BLVD
Practice Address - Street 2:SUIT#1
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-5362
Practice Address - Country:US
Practice Address - Phone:702-778-8922
Practice Address - Fax:702-778-8789
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1639470172Medicaid