Changing The Spectrum, Llc | |
4210 Broadway St Pearland TX 77581-4118 | |
(281) 676-2557 | |
(318) 855-1277 |
Full Name | Changing The Spectrum, Llc |
---|---|
Speciality | Early Intervention Provider Agency |
Location | 4210 Broadway St, Pearland, Texas |
Authorized Official Name and Position | Victoria Johnson (OWNER, BCBA) |
Authorized Official Contact | 3186806422 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Changing The Spectrum, Llc 3411 Whitman Dr Rosharon TX 77583-1204 Ph: (318) 680-6422 | Changing The Spectrum, Llc 4210 Broadway St Pearland TX 77581-4118 Ph: (281) 676-2557 |
NPI Number | 1174087431 |
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Provider Enumeration Date | 01/30/2019 |
Last Update Date | 11/10/2023 |
Certification Date | 11/10/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174087431 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
252Y00000X | Early Intervention Provider Agency | (* (Not Available)) | Primary |
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