Individual
CORTNEY SIMO FOSSOUO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
611 S HIGHWAY 78 STE 124, WYLIE, TX 75098-4134
(972) 429-5700
Mailing address
406 KAMBER LN, WYLIE, TX 75098-4539
(214) 454-2447
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-45990
TX
Other
Enumeration date
10/31/2017
Last updated
07/14/2023
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