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Individual

CHRISTINA BALLYNCY PROCTOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.ED

Contact information

Practice address
9218 WOLCOTT PARK LN, HOUSTON, TX 77075-3824
(713) 298-4785
Mailing address
5900 BALCONES DR STE 100, AUSTIN, TX 78731-4298
(832) 464-6859

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
251C00000X
Developmentally Disabled Services Day Training Agency
252Y00000X
Early Intervention Provider Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MSS1RKLREBU8
SAM ID
TX
Enumeration date
01/10/2022
Last updated
01/10/2022
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