Organization
BRENT WOODALL FOUNDATION FOR EXCEPTIONAL CHILDREN
Active
Other names
Brent Woodall Foundation
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARLEY MICHELE WALTENBURG M.S. (DIRECTOR)
(972) 756-9170
Entity
Organization
Contact information
Practice address
7801 MESQUITE BEND DR STE 105, IRVING, TX 75063-6043
(972) 756-9170
(214) 614-4650
Mailing address
7801 MESQUITE BEND DR STE 105, IRVING, TX 75063-6043
(972) 756-9170
(214) 614-4650
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
05/18/2009
Last updated
04/03/2024
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