Individual
ANGELA WILBURN-PORRAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
6211 SOUTHWEST BLVD, BENBROOK, TX 76132-1080
(817) 691-3283
Mailing address
16800 DALLAS PKWY STE 200, DALLAS, TX 75248-1961
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-12-47863
TX
247200000X
Other Technician
RT-18-52660
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-12-47863
BACB
TX
01
—
RT-18-52660
BACB
—
Enumeration date
02/15/2019
Last updated
02/24/2021
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