Individual
MRS. KELLY LYNNE BIVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1009 PRUITT RD, SPRING, TX 77380-3024
(281) 610-1987
Mailing address
18401 TIMBER FOREST DR, HUMBLE, TX 77346-2535
(281) 852-0501
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-05-2141
TX
103K00000X
Behavior Analyst
1151
TX
Other
Enumeration date
06/03/2010
Last updated
03/17/2020
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