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General NPI Number Information
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NPI Number | 1346059771
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Entity Type | Organization
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Legal Business Name | LILIUM BEHAVIOR CONSULTANTS
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Dates
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Enumeration Date | 12/31/2024
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 933 E. HAMMOND ST.
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City | FORT WORTH
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State | TX
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Zip | 76115
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Country | US
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Telephone | 682-554-8684
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Fax |
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Provider Business Mailing Address
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Address Line | 7548 PRESTON RD STE 141
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City | FRISCO
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State | TX
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Zip | 75034-5689
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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 | CEO
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Name | JENNIFER PIMENTEL
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Credential | MED, BCBA
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Telephone | 682-554-8684
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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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