Individual
MIA LUSK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12224 WIND SURF DR, FRISCO, TX 75036-6503
(863) 797-6664
Mailing address
5522 LONE STAR PKWY STE 101, SAN ANTONIO, TX 78253-6719
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
05/06/2024
Last updated
05/06/2024
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