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Individual

PAULINE DEANNA CUBELIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
314 10TH AVE S STE 100, WAITE PARK, MN 56387-1968
(612) 767-7222
Mailing address
314 10TH AVE S STE 100, WAITE PARK, MN 56387-1968
(612) 767-7222

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
5790
TX
106E00000X
Assistant Behavior Analyst
106S00000X
Behavior Technician
RBT-19-77551
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BCBA-1-23-65077
BACB
TX
01
RBT-19-77551
BACB
TX
Enumeration date
02/07/2019
Last updated
05/12/2025
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