Individual
CARISSA NICOLE PENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
6025 SPORTS VILLAGE RD, FRISCO, TX 75033-3505
(214) 687-9374
Mailing address
2740 COLLEGE AVE, CONWAY, AR 72034-6141
(501) 329-5459
(501) 327-1738
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2441
TX
Other
Enumeration date
02/11/2011
Last updated
02/13/2019
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