Provider Demographics
NPI:1093313082
Name:DEBENEDITTIS, ADRYANA DESIREE (RBT)
Entity Type:Individual
Prefix:
First Name:ADRYANA
Middle Name:DESIREE
Last Name:DEBENEDITTIS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 WARRENVILLE ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-6928
Mailing Address - Country:US
Mailing Address - Phone:702-807-6296
Mailing Address - Fax:
Practice Address - Street 1:408 S JONES BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-2658
Practice Address - Country:US
Practice Address - Phone:702-502-8021
Practice Address - Fax:888-688-9464
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCI5330101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
RBT-20-137259OtherBEHAVIOR ANALYST CERTIFICATION BOARD