| NPI | 1699475509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA LOPEZ Credentialing Director 512-508-3941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 103T00000X Psychologist |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2023-03-08 |
| Last Update Date | 2026-09-01 |