Individual
ALEXIS JADE FAVELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2902 18TH ST, LUBBOCK, TX 79409-9820
(806) 742-4561
Mailing address
2902 18TH ST, LUBBOCK, TX 79409-9820
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
3812
TX
Other
Enumeration date
03/09/2021
Last updated
03/09/2021
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