| NPI | 1578807533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE CONNALLY Credentialing Coordinator 817-759-7931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 11212253) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2012-11-15 |