Individual
MISS MARIAH GONZALES GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1310 W SLAUGHTER LN, AUSTIN, TX 78748-6556
(888) 308-3728
Mailing address
125 PECANWOOD S, KYLE, TX 78640-5265
(361) 739-6824
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-51028
TX
106S00000X
Behavior Technician
RBT-18-48830
TX
Other
Enumeration date
07/11/2019
Last updated
06/30/2021
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