Provider Demographics
NPI:1689948697
Name:BUTLER, JENAYA C
Entity Type:Individual
Prefix:
First Name:JENAYA
Middle Name:C
Last Name:BUTLER
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 1:7450 S EASTERN AVE
Mailing Address - Street 2:2020
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-1557
Mailing Address - Country:US
Mailing Address - Phone:313-574-8200
Mailing Address - Fax:
Practice Address - Street 1:7450 S EASTERN AVE
Practice Address - Street 2:2020
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-1557
Practice Address - Country:US
Practice Address - Phone:313-574-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst