Healthcare Provider Details

I. General information

NPI: 1457926248
Provider Name (Legal Business Name): COURTNEY MIER BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COURTNEY TUCK

II. Dates (important events)

Enumeration Date: 05/24/2021
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 BOSWELL RD STE 180
CHULA VISTA CA
91914-3633
US

IV. Provider business mailing address

2023 LAKERIDGE CIR UNIT 102
CHULA VISTA CA
91913-3303
US

V. Phone/Fax

Practice location:
  • Phone: 800-434-8923
  • Fax: 858-649-6012
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2832950
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: