Individual
BOUSSO DIOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2655 VILLA CREEK DR STE 140, FARMERS BRANCH, TX 75234-7385
(214) 736-8376
Mailing address
2520 HEATHER BROOK LN APT 807, ARLINGTON, TX 76006-5177
(469) 494-2908
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-380996
TX
Other
Enumeration date
10/14/2024
Last updated
10/14/2024
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