Healthcare Provider Details
I. General information
NPI: 1437011038
Provider Name (Legal Business Name): CONTINUING BEHAVIOR SUPPORT TX
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
834 SW 306TH ST
FEDERAL WAY WA
98023
US
IV. Provider business mailing address
5900 BALCONES DR STE 100
AUSTIN TX
78731-4298
US
V. Phone/Fax
- Phone: 253-250-5034
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DEHLIA
CONNOLLY
Title or Position: EXECUTIVE DIRECTOR
Credential: BCBA
Phone: 206-797-5116