Individual
CALLIE VEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7485 PHELAN BLVD, BEAUMONT, TX 77706-5748
(409) 842-9898
Mailing address
7485 PHELAN BLVD, BEAUMONT, TX 77706-5748
(409) 842-9898
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36338967
DL
TX
Enumeration date
07/20/2021
Last updated
07/20/2021
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