Individual
LIZA NICOLE MIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, MS
Contact information
Practice address
7718 MCPHERSON RD STE 105, LAREDO, TX 78045-2816
(956) 516-7009
Mailing address
7718 MCPHERSON RD STE 105, LAREDO, TX 78045-2816
(956) 516-7009
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2704
TX
Other
Enumeration date
09/24/2019
Last updated
05/02/2023
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