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Individual

MRS. ELCA MANUELA EBOULE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
190 CIVIC CIR STE 210, LEWISVILLE, TX 75067-3635
(401) 837-6078
Mailing address
190 CIVIC CIR STE 210, LEWISVILLE, TX 75067-3635
(401) 837-6078

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
S21090278
MA

Other

Enumeration date
05/18/2016
Last updated
05/18/2016
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