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Individual

COLEMIN TY THERIOT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BS, BCABA

Contact information

Practice address
2825 W TOWN CENTER CIR, KINGWOOD, TX 77339-3734
(281) 570-2420
Mailing address
7500 SAN FELIPE ST STE 220, HOUSTON, TX 77063-1724

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
282987
KY
106E00000X
Assistant Behavior Analyst
Primary
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1912592130
TRICARE
KY
Enumeration date
08/27/2021
Last updated
10/02/2025
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