Provider Demographics
NPI:1174133482
Name:HAZELWOOD, MONET JACQUES (RBT)
Entity type:Individual
Prefix:
First Name:MONET
Middle Name:JACQUES
Last Name:HAZELWOOD
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 W ROCHELLE AVE, #121
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103
Mailing Address - Country:US
Mailing Address - Phone:725-242-3628
Mailing Address - Fax:
Practice Address - Street 1:7560 W SAHARA AVE STE 107
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2745
Practice Address - Country:US
Practice Address - Phone:702-283-6215
Practice Address - Fax:702-979-1028
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1-25-80183103K00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician