Provider Demographics
NPI:1558902114
Name:TODDY, DELANEY JENNA (BA)
Entity Type:Individual
Prefix:MS
First Name:DELANEY
Middle Name:JENNA
Last Name:TODDY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5248 PALM PINNACLE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-5682
Mailing Address - Country:US
Mailing Address - Phone:725-710-4529
Mailing Address - Fax:
Practice Address - Street 1:5248 PALM PINNACLE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89139-5682
Practice Address - Country:US
Practice Address - Phone:725-710-4529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-04
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRBT-19-100986106S00000X
NVLBA0745103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
RBT-19-100986OtherBACB
NVLBA0745OtherNEVADA ABA BOARD
1-22-63167OtherBACB