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General NPI Number Information
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NPI Number | 1598588659
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL EDUCATION AND AWARENESS PROGRAMS LLC
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Dates
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Enumeration Date | 11/06/2024
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 121 LITTLE JOHN DR
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City | DESOTO
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State | TX
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Zip | 75115-5911
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Country | US
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Telephone | 469-708-6672
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Fax | 469-209-1395
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Provider Business Mailing Address
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Address Line | 5900 BALCONES DR STE 17177
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City | AUSTIN
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State | TX
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Zip | 78731-4257
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Country | US
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Telephone | 469-708-6672
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Fax | 469-209-1395
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Authorized Official
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Title or Position | BOARD CERTIFIED BEHAVIOR ANALYST
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Name | DESIRE FUENTES MAY
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Credential | MA., MS., BCBA
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Telephone | 469-708-6672
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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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 |
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License Number State |
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