Organization
CHILDS PATH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE BOATMAN M.S., B.C.B.A. (DIRECTOR)
(214) 681-0344
Entity
Organization
Contact information
Practice address
8720 W MAIN ST, FRISCO, TX 75033-3079
(214) 681-0344
(214) 291-5692
Mailing address
PO BOX 864557, PLANO, TX 75086-4557
(214) 681-0344
(214) 291-5692
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-12-12040
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002BF
BCBS
TX
01
—
12347082668
TRICARE
TX
01
—
1316338544
NPI
TX
01
—
1720332117
INDIVIDUAL NPI
TX
01
—
1851718209
NPI
TX
01
—
3639503
UNITED HEALTH CARE
TX
Enumeration date
03/26/2014
Last updated
04/25/2016
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