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General NPI Number Information
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NPI Number | 1003329723
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Entity Type | Individual
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Provider Name | GARY GENE SARLI BCBA, LPA
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Gender | Male
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Dates
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Enumeration Date | 11/16/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 19965 FM 3175
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City | LYTLE
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State | TX
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Zip | 78052-3481
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Country | US
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Telephone | 830-266-5480
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Fax | 830-772-4350
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Provider Business Mailing Address
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Address Line | 19965 FM 3175
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City | LYTLE
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State | TX
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Zip | 78052-3481
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Country | US
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Telephone | 830-266-5480
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Fax | 830-772-4350
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-14-9447
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License Number State | TX
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