Individual
BEAU BRADY KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
1210 STONEHOLLOW DR, KINGWOOD, TX 77339-1789
(281) 312-4434
Mailing address
1210 STONEHOLLOW DR, KINGWOOD, TX 77339-1789
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
19-88234
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106S000000X
BEHAVIOR TECHNICIAN
TX
Enumeration date
05/17/2021
Last updated
05/17/2021
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