Individual
MARIEL CREMONIE FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
10503 METRIC DR, DALLAS, TX 75243-5514
(972) 644-2076
(972) 644-5650
Mailing address
10503 METRIC DRIVE, DALLAS, TX 75243
(972) 644-2076
(972) 644-5650
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-04-2082
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-04-2082
MS, BCBA
TX
01
—
1-04-2082
BCBA
—
Enumeration date
01/24/2011
Last updated
05/27/2015
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