Healthcare Provider Details

I. General information

NPI: 1912584095
Provider Name (Legal Business Name): ERIN MIXON-SORIANO BCBA,LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22001 NORTHPARK DR STE 400
KINGWOOD TX
77339-3809
US

IV. Provider business mailing address

22001 NORTHPARK DR STE 400
KINGWOOD TX
77339-3809
US

V. Phone/Fax

Practice location:
  • Phone: 281-919-9622
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-21-161199
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-23-69277
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: