Individual
MAMOUN RAFATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
3402 TREEFROG TRL, SAN ANTONIO, TX 78253
(210) 748-3690
Mailing address
3402 TREEFROG TRL, SAN ANTONIO, TX 78253-6385
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-27086
TX
Other
Enumeration date
09/25/2017
Last updated
09/25/2017
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