Provider Demographics
NPI:1730477951
Name:ROBLEZ, RAY
Entity Type:Individual
Prefix:
First Name:RAY
Middle Name:
Last Name:ROBLEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 E SAHARA AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-3735
Mailing Address - Country:US
Mailing Address - Phone:702-207-6782
Mailing Address - Fax:702-207-6791
Practice Address - Street 1:1810 E SAHARA AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3735
Practice Address - Country:US
Practice Address - Phone:702-207-6782
Practice Address - Fax:702-207-6791
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst