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NPI Code Detail

MEDICARE: ROBYN A CLARK BCBA, LBA

MEDICARE: ROBYN A CLARK BCBA, LBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-19-39267TX

General Provider Information

NPI Number : 1447714159
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBYN A CLARK BCBA, LBA
Provider Business Mailing Address
First Line : 8260 PRECINCT LINE RD
Second Line :
City : NORTH RICHLAND HILLS
State : TX
Zip : 76182-8608
Country : US
Telephone Number : 817-717-6060
Fax Number :
Provider Business Practice Location Address
First Line : 8260 PRECINCT LINE RD
Second Line :
City : NORTH RICHLAND HILLS
State : TX
Zip : 76182-8608
Country : US
Telephone Number : 817-717-6060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2019
Last Update Date : 08/24/2022

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