Individual
BLANCA P BAUTISTA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
255 LEBANON RD, STE 212, FRISCO, TX 75036-3404
(855) 782-7822
Mailing address
5522 LONE STAR PKWY STE 101, SAN ANTONIO, TX 78253-6719
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/06/2024
Last updated
05/09/2024
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