Organization
KTL BEHAVIORAL THERAPY & CONSULTATION PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA BERNARD MOON BCBA (MANAGER)
(763) 439-0303
Entity
Organization
Contact information
Practice address
1603 SANCHEZ ST, UNIT A, AUSTIN, TX 78702-1640
(763) 439-0303
Mailing address
1603 SANCHEZ ST, UNIT A, AUSTIN, TX 78702-1640
(763) 439-0303
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/25/2013
Last updated
06/03/2016
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