Individual
AUSTIN TANNER GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
3963 BOAT CLUB RD, LAKE WORTH, TX 76135-3202
(214) 628-5726
Mailing address
5545 WEDGWOOD DR, FORT WORTH, TX 76133-2538
(469) 902-0322
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/30/2020
Last updated
04/22/2026
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