Individual
CANYON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
29543 AUTUMN COPPER, BULVERDE, TX 78163-2615
(575) 749-9033
Mailing address
29543 AUTUMN COPPER, BULVERDE, TX 78163-2615
(575) 749-9033
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12476576
TX
106S00000X
Behavior Technician
BACB794096
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080313
—
NM
Enumeration date
06/12/2022
Last updated
06/09/2025
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