Healthcare Provider Details

I. General information

NPI: 1649769415
Provider Name (Legal Business Name): KAITLIN LANGSTON BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2018
Last Update Date: 12/19/2024
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32502 TAMINA RD STE 100
MAGNOLIA TX
77354-7451
US

IV. Provider business mailing address

7500 SAN FELIPE ST. STE 99
HOUSTON TX
77063
US

V. Phone/Fax

Practice location:
  • Phone: 936-206-5158
  • Fax: 346-229-1675
Mailing address:
  • Phone: 281-826-3382
  • Fax: 425-491-7683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: