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General NPI Number Information
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NPI Number | 1184206203
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Entity Type | Individual
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Provider Name | KAYLA LUCES
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Gender | Female
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Dates
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Enumeration Date | 04/27/2021
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Last Update Date | 04/27/2021
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Provider Practice Location Address
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Address Line | 615 CHASEWAY DR
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City | MISSOURI CITY
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State | TX
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Zip | 77489-3215
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Country | US
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Telephone | 832-758-0242
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Fax |
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Provider Business Mailing Address
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Address Line | 1 UTSA CIR
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City | SAN ANTONIO
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State | TX
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Zip | 78249-1644
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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 |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | BACB676358
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License Number State | TX
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