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Individual

MARJORIE EASTLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
8501 WADE BLVD STE 1250, FRISCO, TX 75034-5894
(972) 312-8733
Mailing address
6105 WINDCOM CT STE 400, PLANO, TX 75093-9003
(972) 312-8733
(972) 378-4747

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
5631
TX
106S00000X
Behavior Technician

Other

Enumeration date
10/19/2021
Last updated
02/06/2023
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