Individual
ANTHONY PENISTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
773 BANDIT TRL, KELLER, TX 76248-0111
(817) 442-9022
Mailing address
4917 PARK OAK CT, FORT WORTH, TX 76137-4186
(817) 470-2018
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/02/2022
Last updated
11/02/2022
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