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NPI 1295122240

NPI 1295122240 : FANG YU LIN BCBA : AUSTIN, TX

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General NPI Number Information
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    NPI Number           |    1295122240
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    Entity Type          |    Individual 
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    Provider Name        |    FANG YU LIN BCBA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/16/2015
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    Last Update Date     |    04/16/2015
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Provider Practice Location Address
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    Address Line         |    7122 WOOD HOLLOW DR APT 3 
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78731-2544
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    Country              |    US
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    Telephone            |    512-433-9888
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7122 WOOD HOLLOW DR APT 3 
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78731-2544
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    Country              |    US
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    Telephone            |    512-433-9888
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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       |    11518198
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    License Number State |    TX
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