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5850 Granite Pkwy Ste 600 Plano TX 75024-6753 | |
| (817) 908-5992 | |
| (818) 758-8015 |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 5850 Granite Pkwy Ste 600, Plano, Texas |
| Authorized Official Name and Position | Jennifer Webster (CEO) |
| Authorized Official Contact | 8183452345 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5850 Granite Pkwy Ste 600 Plano TX 75024-6753 Ph: (818) 345-2345 | 5850 Granite Pkwy Ste 600 Plano TX 75024-6753 Ph: (817) 908-5992 |
| NPI Number | 1669651675 |
|---|---|
| Provider Enumeration Date | 10/25/2007 |
| Last Update Date | 12/01/2022 |
| Certification Date | 12/01/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669651675 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 252Y00000X | Early Intervention Provider Agency | (* (Not Available)) | Secondary |
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