Individual
KIMBERLY TRAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6301 CAMPUS CIRCLE DR E, IRVING, TX 75063-2712
(817) 249-4807
Mailing address
2905 EMERSON LN, DENTON, TX 76209-1556
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-08-3979
TX
Other
Enumeration date
08/14/2013
Last updated
08/14/2013
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