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14090 Southwest Fwy, Suite 300 #788 Sugar Land TX 77478 | |
| (213) 293-4393 | |
| (346) 699-0169 |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 14090 Southwest Fwy,, Sugar Land, Texas |
| Authorized Official Name and Position | Danita Lashawn Ealy (OWNER/CLINICAL DIRECTOR) |
| Authorized Official Contact | 2132934393 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2202 Welborn Dr Missouri City TX 77459 Ph: (213) 293-4393 | 14090 Southwest Fwy, Suite 300 #788 Sugar Land TX 77478 Ph: (213) 293-4393 |
| NPI Number | 1912749672 |
|---|---|
| Provider Enumeration Date | 06/12/2024 |
| Last Update Date | 10/24/2024 |
| Certification Date | 10/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912749672 | NPI | - | NPPES |
| 432112701 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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