Individual
MS. PHYLLIS APPLE SAMPLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.C.B.A.
Contact information
Practice address
4015 SABLE OAKS DR, ROUND ROCK, TX 78664-6254
(512) 248-0644
Mailing address
4015 SABLE OAKS DR, ROUND ROCK, TX 78664-6254
(512) 248-0644
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
BACB # 1-06-2656
TX
Other
Enumeration date
01/01/2008
Last updated
01/01/2008
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