Provider Demographics
NPI:1023414935
Name:ABDEL-AL, RWIDA (MED, BCBA, LABA)
Entity type:Individual
Prefix:
First Name:RWIDA
Middle Name:
Last Name:ABDEL-AL
Suffix:
Gender:F
Credentials:MED, BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7341 RESTFUL SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-4303
Mailing Address - Country:US
Mailing Address - Phone:702-563-7852
Mailing Address - Fax:
Practice Address - Street 1:331 N BUFFALO DR
Practice Address - Street 2:STE B
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-0300
Practice Address - Country:US
Practice Address - Phone:702-877-2520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1-14-15430103K00000X
NV0002103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst