Individual
MRS. KADIE ELIZABETH BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA., BCBA, LBA
Contact information
Practice address
1652 KELLER PKWY STE 200, KELLER, TX 76248-3877
(682) 291-9910
Mailing address
308 RANCHITO PASS, HASLET, TX 76052-3647
(817) 899-4659
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
4748
TX
Other
Enumeration date
10/16/2019
Last updated
09/06/2023
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