Basic Information
| Provider Information | |||||||||
| NPI: | 1679072854 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAWTON | ||||||||
| FirstName: | ANGELA | ||||||||
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| Credential: | BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8989 OCEANSIDE SLOPES AVE | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891787525 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7024930019 | ||||||||
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| Practice Location | |||||||||
| Address1: | 408 S JONES BLVD | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891072658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7025028021 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2018 | ||||||||
| LastUpdateDate: | 12/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | RBT-19-75360 | NV | N | 103K00000X | 1-20-46598 | NV | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.