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General NPI Number Information
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NPI Number | 1285392241
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Entity Type | Individual
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Provider Name | CHRYSTIN NICOLE CANALES MA, BCBA
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Gender | Female
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Dates
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Enumeration Date | 12/07/2021
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Last Update Date | 04/28/2022
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Provider Practice Location Address
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Address Line | 2612 LONG PRAIRIE RD STE B
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City | FLOWER MOUND
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State | TX
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Zip | 75022-4981
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Country | US
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Telephone | 855-782-7822
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Fax |
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Provider Business Mailing Address
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Address Line | 3200 S INTERSTATE 35 E APT 4102
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City | DENTON
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State | TX
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Zip | 76210-6921
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Country | US
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Telephone | 361-389-1498
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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 | RBT-18-61670
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-22-59220
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License Number State | TX
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