Individual
MARY REEVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2417 PRESIDIO VISTA DR, FORT WORTH, TX 76177-8277
(682) 316-9008
Mailing address
2417 PRESIDIO VISTA DR, FORT WORTH, TX 76177-8277
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-67169
TX
106S00000X
Behavior Technician
RBT-17-38177
TX
Other
Enumeration date
01/18/2022
Last updated
09/24/2023
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