Individual
MIA HOLDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
12371 S KIRKWOOD RD, STAFFORD, TX 77477-2836
(713) 773-5180
Mailing address
1015 HONEYSUCKLE VINE DR, ROSENBERG, TX 77469-4860
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
3185
TX
Other
Enumeration date
03/17/2020
Last updated
03/17/2020
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