Organization
THE SHAPE OF BEHAVIOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DOMONIQUE Y RANDALL M.S. BCBA (OWNER)
(832) 358-2655
Entity
Organization
Contact information
Practice address
12941 NORTH FWY, STE 750, HOUSTON, TX 77060-1240
(832) 358-2655
(832) 359-3530
Mailing address
12941 NORTH FWY, STE 750, HOUSTON, TX 77060-1240
(832) 358-2655
(832) 359-3530
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1-00-0350
TX
Other
Enumeration date
06/25/2007
Last updated
08/18/2015
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