Provider Demographics
NPI:1134637564
Name:CLAIBORNE, NICOLE
Entity Type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:
Last Name:CLAIBORNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4525 S SANDHILL RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-5954
Mailing Address - Country:US
Mailing Address - Phone:702-831-8949
Mailing Address - Fax:702-750-9009
Practice Address - Street 1:4525 S SANDHILL RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5954
Practice Address - Country:US
Practice Address - Phone:702-831-8949
Practice Address - Fax:702-750-9009
Is Sole Proprietor?:No
Enumeration Date:2018-01-19
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst