Provider Demographics
NPI:1942621610
Name:THIEL, ALEXANDER CLAUDE
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:CLAUDE
Last Name:THIEL
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 1:3560 W CHEYENNE AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-8261
Mailing Address - Country:US
Mailing Address - Phone:702-258-8023
Mailing Address - Fax:702-258-8024
Practice Address - Street 1:3560 W CHEYENNE AVE STE 130
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-8261
Practice Address - Country:US
Practice Address - Phone:702-258-8023
Practice Address - Fax:702-258-8024
Is Sole Proprietor?:No
Enumeration Date:2013-12-26
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst