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Individual

AIMEE NICOLE PORTILLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2105 E PARK ST, CEDAR PARK, TX 78613-4598
(512) 588-1362
(512) 792-4834
Mailing address
2300 WOLF RANCH PKWY APT 1207, GEORGETOWN, TX 78628-7287
(512) 968-5667

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
106S00000X
Behavior Technician
RBT-17-41036
TX

Other

Enumeration date
01/22/2018
Last updated
05/18/2022
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