Provider Demographics
NPI:1891218475
Name:RAINFORD, CHANTAL (BCBA, LBA, MS)
Entity Type:Individual
Prefix:
First Name:CHANTAL
Middle Name:
Last Name:RAINFORD
Suffix:
Gender:F
Credentials:BCBA, LBA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7730 W SAHARA AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2753
Mailing Address - Country:US
Mailing Address - Phone:702-660-2005
Mailing Address - Fax:702-660-4808
Practice Address - Street 1:7730 W SAHARA AVE STE 115
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2753
Practice Address - Country:US
Practice Address - Phone:702-660-2005
Practice Address - Fax:702-620-4808
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-25
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV16-7378106E00000X
1-19-34900103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty