Organization
NORTH TEXAS DIAGNOSTIC INTERVENTION BEHAVIORAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL SAMANTHA BERTELSON BCBA, LBA, LPA-I PHD (SUPERVISING BCBA, LPA-I)
(940) 386-2100
Entity
Organization
Contact information
Practice address
3501 SHEPPARD ACCESS RD, WICHITA FALLS, TX 76306-4235
(940) 447-7115
Mailing address
3501 SHEPPARD ACCESS RD, WICHITA FALLS, TX 76306-4235
(940) 867-7929
(940) 386-2100
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
05/22/2019
Last updated
04/26/2021
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