Individual
MICHELLE CHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2401 MUSTANG DR, GRAPEVINE, TX 76051-8640
(817) 722-6118
Mailing address
2401 MUSTANG DR, GRAPEVINE, TX 76051-8640
(817) 722-6118
(817) 442-0223
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-46686
TX
106S00000X
Behavior Technician
RBT-19-82183
TX
Other
Enumeration date
04/10/2019
Last updated
03/30/2021
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