Individual
MS. ESMERALDA REBOLLOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
10503 METRIC DR, DALLAS, TX 75243-5514
(972) 644-2076
Mailing address
10328 HILLHOUSE LN, DALLAS, TX 75227-7650
(214) 412-9144
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-44562
TX
106S00000X
Behavior Technician
RBT-18-50407
TX
Other
Enumeration date
05/23/2018
Last updated
06/15/2021
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