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General NPI Number Information
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NPI Number | 1447598255
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Entity Type | Individual
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Provider Name | KRIS BEAUDREAULT LBA, BCBA
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Gender | Female
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Dates
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Enumeration Date | 01/29/2013
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Last Update Date | 09/08/2020
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Provider Practice Location Address
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Address Line | 1325 SPACE PARK DR STE B&C
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City | HOUSTON
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State | TX
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Zip | 77058-3459
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Country | US
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Telephone | 713-355-0623
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Fax |
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Provider Business Mailing Address
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Address Line | 2531 ATTWATER WAY
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City | LEAGUE CITY
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State | TX
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Zip | 77573-7775
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Country | US
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Telephone | 413-552-6648
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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 | 1-11-8877
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License Number State | CA
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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 | 2460
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License Number State | TX
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