Provider Demographics
NPI:1093217507
Name:FINNEGAN, TIFFANY ANN (BCBA)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:ANN
Last Name:FINNEGAN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8072 W SAHARA AVE STE D
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-1974
Mailing Address - Country:US
Mailing Address - Phone:725-205-3628
Mailing Address - Fax:702-552-2449
Practice Address - Street 1:8072 W SAHARA AVE STE D
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1974
Practice Address - Country:US
Practice Address - Phone:725-205-3628
Practice Address - Fax:702-552-2449
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-20-44377103K00000X
NVLBA0352103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1033845822Medicaid