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General NPI Number Information
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NPI Number | 1740171636
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Entity Type | Organization
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Legal Business Name | DEEP BLUE BEHAVIOR THERAPY
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Dates
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Enumeration Date | 07/10/2025
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 10339 TWISTING SPRINGS DR
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City | AUBREY
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State | TX
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Zip | 76227-1054
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Country | US
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Telephone | 469-279-3725
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Fax |
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Provider Business Mailing Address
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Address Line | 1710 KELLER PKWY # 2910
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City | KELLER
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State | TX
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Zip | 76248-3749
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Country | US
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Telephone | 469-279-3725
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LUISA HARMAN-BAEZ
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Credential |
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Telephone | 469-279-3725
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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 |
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License Number State |
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