Organization
EASTER SEALS NORTH TEXAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BONNIE CONNALLY (CREDENTIALING COORDINATOR)
(817) 759-7931
Entity
Organization
Contact information
Practice address
1900 ELM ST, # 810, DALLAS, TX 75201-4527
(972) 939-3911
(972) 394-6266
Mailing address
1900 ELM ST, # 810, DALLAS, TX 75201-4527
(972) 939-3911
(972) 394-6266
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11212253
TX
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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