| NPI | 1730066226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA L GOMEZ Credentialing Manager 512-508-3941 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-08-18 |
| Last Update Date | 2025-08-18 |