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General NPI Number Information
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NPI Number | 1285370205
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Entity Type | Organization
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Legal Business Name | A SPECIAL PEACE
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Dates
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Enumeration Date | 05/11/2022
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Last Update Date | 05/15/2022
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Provider Practice Location Address
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Address Line | 17507 STERLING STONE DR
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City | HOUSTON
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State | TX
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Zip | 77073-2765
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Country | US
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Telephone | 713-380-5248
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Fax |
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Provider Business Mailing Address
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Address Line | 17507 STERLING STONE DR
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City | HOUSTON
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State | TX
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Zip | 77073-2765
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Country | US
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Telephone | 713-380-5248
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KISHA WILSON
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Credential | M.ED., BCBA, LBA
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Telephone | 713-380-5248
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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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