Healthcare Provider Details

I. General information

NPI: 1154554210
Provider Name (Legal Business Name): HAPPY KIDS AUTISM INTERVENTION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2009
Last Update Date: 08/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1103 SMITH LN
BRUCEVILLE TX
76630-3256
US

IV. Provider business mailing address

1103 SMITH LN
BRUCEVILLE TX
76630-3256
US

V. Phone/Fax

Practice location:
  • Phone: 254-716-8743
  • Fax:
Mailing address:
  • Phone: 254-716-8743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA SUZANNE SCOTT
Title or Position: OWNER, EXECUTIVE DIRECTOR
Credential: BCBA
Phone: 254-716-8743