Provider Demographics
NPI:1518576214
Name:WEBSTER, MICHAEL LOUIS-NORMAN I (RBT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:LOUIS-NORMAN
Last Name:WEBSTER
Suffix:I
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6671 LAS VEGAS BLVD S STE 210
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-3273
Mailing Address - Country:US
Mailing Address - Phone:310-406-1500
Mailing Address - Fax:
Practice Address - Street 1:6671 LAS VEGAS BLVD S STE 210
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-3273
Practice Address - Country:US
Practice Address - Phone:310-406-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician