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NPI Code Detail

MEDICARE: AMY WANG M.ED., BCBA, LBA

MEDICARE: AMY WANG M.ED., 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 Analyst2550TX

General Provider Information

NPI Number : 1861961146
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY WANG M.ED., BCBA, LBA
Provider Business Mailing Address
First Line : 7435 HIGHWAY 6 STE F
Second Line :
City : MISSOURI CITY
State : TX
Zip : 77459-5135
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7435 HIGHWAY 6 STE F
Second Line :
City : MISSOURI CITY
State : TX
Zip : 77459-5135
Country : US
Telephone Number : 832-539-1289
Fax Number : 832-539-6271
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2018
Last Update Date : 11/16/2018

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