=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386185015
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HAPPY KIDS AUTISM INTERVENTION SERVICES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/14/2017
-----------------------------------------------------
Last Update Date | 08/22/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 703 W FM 2410 RD
-----------------------------------------------------
City | HARKER HEIGHTS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76548-1607
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 254-716-8743
-----------------------------------------------------
Fax | 254-227-6027
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 703 W FM 2410 RD
-----------------------------------------------------
City | HARKER HEIGHTS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76548-1607
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 254-716-8743
-----------------------------------------------------
Fax | 254-227-6027
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | PATRICIA SUZANNE STEWART
-----------------------------------------------------
Credential | BCBA
-----------------------------------------------------
Telephone | 254-716-8743
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------