Provider Demographics
NPI:1225564578
Name:HADDAD, LOUIS (RBT-17-33338)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:HADDAD
Suffix:
Gender:M
Credentials:RBT-17-33338
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 MARSH CREEK CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-0939
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:731 MALL RING CIR
Practice Address - Street 2:SUITE 215
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-6683
Practice Address - Country:US
Practice Address - Phone:702-547-6971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-05
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRBT-17-33338103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVRBT-17-33338OtherRBT-17-33338