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General NPI Number Information
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NPI Number | 1619203361
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Entity Type | Organization
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Legal Business Name | GREATER SOUTHWEST GROUP CORPORATION
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Dates
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Enumeration Date | 10/29/2009
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Last Update Date | 10/29/2009
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Provider Practice Location Address
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Address Line | 316 W BELT LINE RD SUITE 202
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City | CEDAR HILL
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State | TX
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Zip | 75104-2049
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Country | US
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Telephone | 972-955-2879
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Fax | 972-293-9183
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Provider Business Mailing Address
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Address Line | 316 W BELT LINE RD SUITE 202
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City | CEDAR HILL
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State | TX
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Zip | 75104-2049
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Country | US
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Telephone | 972-955-2879
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Fax | 972-293-9183
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Authorized Official
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Title or Position | SECRETARY
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Name | ALEXIS NORMAN
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Credential |
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Telephone | 972-955-2879
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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 | 18630
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License Number State | TX
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