Organization
CENTER FOR SPECTRUM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKYUNG PARK BCBA (CEO)
(949) 903-5585
Entity
Organization
Contact information
Practice address
25306 BASIL BROOK CT, KATY, TX 77494-3178
(949) 903-5585
Mailing address
25306 BASIL BROOK CT, KATY, TX 77494-3178
(949) 903-5585
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
02/05/2021
Last updated
02/05/2021
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