Individual
JONATHAN LUCAS MEDLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BEHAVIOR ANALYST
Contact information
Practice address
12430 GRANT RD STE A, CYPRESS, TX 77429-7912
(855) 782-7822
Mailing address
12430 GRANT RD STE A, CYPRESS, TX 77429-7912
(855) 782-7822
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
7182
TX
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/05/2021
Last updated
09/24/2024
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