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316 N Gray St Killeen TX 76541-5245 | |
| (419) 618-1135 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 316 N Gray St, Killeen, Texas |
| Authorized Official Name and Position | Cheryl Durgin (OWNER) |
| Authorized Official Contact | 2543175603 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 360 Killeen TX 76540-0360 Ph: (419) 618-1135 | 316 N Gray St Killeen TX 76541-5245 Ph: (419) 618-1135 |
| NPI Number | 1861907875 |
|---|---|
| Provider Enumeration Date | 12/13/2017 |
| Last Update Date | 01/04/2021 |
| Certification Date | 01/04/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861907875 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
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