Healthcare Provider Details

I. General information

NPI: 1821832866
Provider Name (Legal Business Name): JORDAN LEIGH STANLEY SPENCE BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JORDAN LEIGH STANLEY BCBA

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22323 BRUSHY WOODLAND EDGE WAY
CYPRESS TX
77433-8570
US

IV. Provider business mailing address

22323 BRUSHY WOODLAND EDGE WAY
CYPRESS TX
77433-8570
US

V. Phone/Fax

Practice location:
  • Phone: 832-407-0785
  • Fax:
Mailing address:
  • Phone: 832-407-0785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-23-66124
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: