| NPI | 1104166776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA MULLICAN Behavior Interventionist 769-218-9596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 251S00000X |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2013-02-19 |
| Last Update Date | 2013-02-19 |