| Thrive Advanced Care Llc | |
|
406 Kamber Ln Wylie TX 75098-4539 | |
| (214) 454-2447 | |
| Not Available |
| Full Name | Thrive Advanced Care Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 406 Kamber Ln, Wylie, Texas |
| Authorized Official Name and Position | Cortney C Simo Fossouo (BOARD CERTIFIED BEHAVIOR ANAYLST) |
| Authorized Official Contact | 2144542447 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thrive Advanced Care Llc 406 Kamber Ln Wylie TX 75098-4539 Ph: (214) 454-2447 | Thrive Advanced Care Llc 406 Kamber Ln Wylie TX 75098-4539 Ph: (214) 454-2447 |
| NPI Number | 1447903893 |
|---|---|
| Provider Enumeration Date | 01/26/2022 |
| Last Update Date | 07/14/2023 |
| Certification Date | 07/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447903893 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 2355S0801X | Specialist/technologist - Speech-language Assistant | (* (Not Available)) | Secondary |
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