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General NPI Number Information
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NPI Number | 1154953941
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Entity Type | Individual
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Provider Name | JULLISA A NAVARRO BCBA
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Gender | Female
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Dates
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Enumeration Date | 02/10/2020
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | 2000 N MAYS ST STE 113
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City | ROUND ROCK
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State | TX
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Zip | 78664-2166
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Country | US
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Telephone | 512-994-4201
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Fax |
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Provider Business Mailing Address
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Address Line | 207 ELMHURST
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City | KYLE
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State | TX
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Zip | 78640-5981
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Country | US
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Telephone | 737-248-7042
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Fax | 512-519-8781
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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 | 1-23-70084
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License Number State | TX
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