Healthcare Provider Details

I. General information

NPI: 1407478175
Provider Name (Legal Business Name): ANDREA CAMP BCBA,LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2020
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6102 82ND ST STE 10
LUBBOCK TX
79424-0802
US

IV. Provider business mailing address

6102 82ND ST STE 10
LUBBOCK TX
79424-0802
US

V. Phone/Fax

Practice location:
  • Phone: 806-993-3333
  • Fax:
Mailing address:
  • Phone: 806-993-3333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-18-64946
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number8897
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: