Individual
KAILEY RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
855 ROLLINGBROOK DR, BAYTOWN, TX 77521-4073
(281) 839-2789
Mailing address
855 ROLLINGBROOK DR, BAYTOWN, TX 77521-4073
(281) 839-2789
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
TX
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
RBT-20-146242
—
Other
Enumeration date
11/25/2020
Last updated
09/03/2024
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