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General NPI Number Information
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NPI Number | 1013572577
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Entity Type | Organization
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Legal Business Name | INDIVIDUALIZED INTERVENTION ABA
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Dates
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Enumeration Date | 05/09/2019
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Last Update Date | 08/22/2023
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Provider Practice Location Address
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Address Line | 1400 BROADFIELD BLVD STE 200
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City | HOUSTON
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State | TX
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Zip | 77084-5162
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Country | US
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Telephone | 832-693-2012
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 BROADFIELD BLVD STE 200
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City | HOUSTON
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State | TX
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Zip | 77084-5162
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DAISY SALDIVAR
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Credential |
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Telephone | 832-693-2012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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