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General NPI Number Information
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NPI Number | 1194480236
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Entity Type | Individual
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Provider Name | AMY HOUGHTALING BCBA, LBA
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Gender | Female
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Dates
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Enumeration Date | 11/03/2021
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Last Update Date | 11/03/2021
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Provider Practice Location Address
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Address Line | 400 AIRPORT RD
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City | TERRELL
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State | TX
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Zip | 75160-4302
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Country | US
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Telephone | 972-388-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 2409 KIRBY RD
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City | ROWLETT
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State | TX
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Zip | 75088-6107
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Country | US
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Telephone | 512-517-5771
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 3148
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License Number State | TX
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