| North Texas Diagnostic Intervention Behavioral Clinic | |
|
3501 Sheppard Access Rd Wichita Falls TX 76306-4235 | |
| (940) 447-7115 | |
| Not Available |
| Full Name | North Texas Diagnostic Intervention Behavioral Clinic |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3501 Sheppard Access Rd, Wichita Falls, Texas |
| Authorized Official Name and Position | Rachel Samantha Bertelson (SUPERVISING BCBA, LPA-I) |
| Authorized Official Contact | 9403862100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Texas Diagnostic Intervention Behavioral Clinic 3501 Sheppard Access Rd Wichita Falls TX 76306-4235 Ph: (940) 867-7929 | North Texas Diagnostic Intervention Behavioral Clinic 3501 Sheppard Access Rd Wichita Falls TX 76306-4235 Ph: (940) 447-7115 |
| NPI Number | 1902463276 |
|---|---|
| Provider Enumeration Date | 05/22/2019 |
| Last Update Date | 04/26/2021 |
| Certification Date | 04/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902463276 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
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