Individual
ANNA LARIONOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1205 SAM BASS RD, ROUND ROCK, TX 78681-4247
(512) 807-0551
Mailing address
1205 SAM BASS RD, AUSTIN, TX 78681-4247
(512) 701-6236
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
TX
Other
Enumeration date
05/08/2023
Last updated
05/08/2023
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