Individual
MARLENE TAVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 REGENCY PKWY, MANSFIELD, TX 76063-5638
(682) 400-0305
Mailing address
201 REGENCY PKWY, MANSFIELD, TX 76063-5638
(682) 400-0305
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-42850
TX
Other
Enumeration date
06/30/2020
Last updated
09/01/2020
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