Individual
MISS KATY RAE TERRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., BCBA, LBA
Contact information
Practice address
7485 PHELAN BLVD, BEAUMONT, TX 77706-5748
(409) 842-9898
Mailing address
7485 PHELAN BLVD, BEAUMONT, TX 77706-5748
(409) 842-9898
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
5602
TX
106E00000X
Assistant Behavior Analyst
—
TX
106S00000X
Behavior Technician
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-21-158432
REGISTERED BEHAVIOR TECHNICIAN
TX
Enumeration date
05/31/2021
Last updated
01/13/2023
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