Provider Demographics
NPI:1528574365
Name:WALLING, CIERRA PATRICIA (BCBA)
Entity Type:Individual
Prefix:
First Name:CIERRA
Middle Name:PATRICIA
Last Name:WALLING
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 N GREEN VALLEY PKWY # 440-604
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-6170
Mailing Address - Country:US
Mailing Address - Phone:702-900-7179
Mailing Address - Fax:
Practice Address - Street 1:3037 E WARM SPRINGS RD STE 200-13
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3758
Practice Address - Country:US
Practice Address - Phone:702-900-7179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-15
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBEH-000527103K00000X
WA60771903106S00000X
NVLBA0528103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician