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Organization
INTERNATIONAL CENTER FOR AUTISM
Active
Organization
INTERNATIONAL CENTER FOR AUTISM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY REED (SECRETARY)
(214) 772-4664
Entity
Organization
Contact information
Practice address
1220 REBA MACENTIRE LN, DENISON, TX 75020-9057
(214) 772-4664
Mailing address
1220 REBA MACENTIRE LN, DENISON, TX 75020-9057
(214) 772-4664
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
NULL
101YP1600X
Pastoral Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
NULL
103K00000X
Behavior Analyst
Primary
—
—
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
NULL
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
NULL
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
106S00000X
Behavior Technician
—
NULL
106S00000X
Behavior Technician
—
—
207ZN0500X
Neuropathology Physician
—
NULL
207ZN0500X
Neuropathology Physician
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
NULL
251V00000X
Voluntary or Charitable Agency
—
NULL
252Y00000X
Early Intervention Provider Agency
—
NULL
261Q00000X
Clinic/Center
—
NULL
Other
Enumeration date
02/17/2022
Last updated
02/17/2022
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