Provider Demographics
NPI:1063751329
Name:BALIGIAN, JEFFREY VARKIS
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:VARKIS
Last Name:BALIGIAN
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 1:10755 WILDHURST ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-4699
Mailing Address - Country:US
Mailing Address - Phone:702-497-7605
Mailing Address - Fax:
Practice Address - Street 1:2340 PASEO DEL PRADO
Practice Address - Street 2:B-D206
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-4360
Practice Address - Country:US
Practice Address - Phone:702-569-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst