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General NPI Number Information
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NPI Number | 1235810086
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Entity Type | Organization
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Legal Business Name | COMPASS AUTISM THERAPY LLC
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Dates
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Enumeration Date | 07/25/2023
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Last Update Date | 07/25/2023
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Provider Practice Location Address
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Address Line | 26922 MARLAN FOREST LN
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City | CYPRESS
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State | TX
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Zip | 77433-1632
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Country | US
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Telephone | 281-785-1160
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Fax |
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Provider Business Mailing Address
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Address Line | 26922 MARLAN FOREST LN
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City | CYPRESS
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State | TX
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Zip | 77433-1632
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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 | CHIEF EXECUTIVE OFFICER
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Name | LAURA TOLLIVER
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Credential | M.ED., BCBA, LBA
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Telephone | 281-785-1160
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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 |
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License Number State |
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