Individual
CARISSA LYNN INCORVAIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4003 W STAN SCHLUETER LOOP STE 3, KILLEEN, TX 76549-6120
(254) 630-1578
Mailing address
4003 W STAN SCHLUETER LOOP STE 3, KILLEEN, TX 76549-6120
(254) 630-1578
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
TX
Other
Enumeration date
07/21/2020
Last updated
07/21/2020
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