Provider Demographics
NPI:1174080832
Name:ALLEYNE-THOMAS, PATRICIA-ANN
Entity type:Individual
Prefix:
First Name:PATRICIA-ANN
Middle Name:
Last Name:ALLEYNE-THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 E RENO AVE UNIT 215
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-2186
Mailing Address - Country:US
Mailing Address - Phone:702-478-7481
Mailing Address - Fax:
Practice Address - Street 1:3481 E SUNSET RD STE 110B
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-6207
Practice Address - Country:US
Practice Address - Phone:702-802-1368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-17-34939106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician