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General NPI Number Information
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NPI Number | 1538095294
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Entity Type | Organization
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Legal Business Name | BLUE SPRIG AUTISM
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Dates
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Enumeration Date | 06/22/2026
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Last Update Date | 06/22/2026
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Provider Practice Location Address
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Address Line | 1652 KELLER PKWY STE 200
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City | KELLER
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State | TX
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Zip | 76248-3877
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Country | US
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Telephone | 682-291-9910
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Fax |
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Provider Business Mailing Address
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Address Line | 2317 BRENDA LN
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City | KELLER
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State | TX
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Zip | 76262-6827
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Country | US
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Telephone | 814-681-4370
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Fax |
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Authorized Official
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Title or Position | BT
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Name | LAUREL REYNOLDS
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Credential |
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Telephone | 814-681-4370
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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 |
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License Number State |
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