Individual
JOTHI MALAR KUPPUSAMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1825 FORTVIEW ROAD, SUITE 105, AUSTIN, TX 78704-7657
(512) 351-7837
(512) 900-1275
Mailing address
1825 FORTVIEW RD, SUITE 105, AUSTIN, TX 78704-7657
(512) 351-7837
(512) 900-1275
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-19246
TX
Other
Enumeration date
07/22/2015
Last updated
07/22/2015
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