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General NPI Number Information
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NPI Number | 1790333250
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Entity Type | Individual
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Provider Name | COSETTE HOPE DUQUENOY-WILKS BCBA 1-22-62790
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Gender | Female
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Dates
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Enumeration Date | 08/28/2019
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Last Update Date | 08/23/2023
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Provider Practice Location Address
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Address Line | 920 HIGHWAY 352 STE 200
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City | MESQUITE
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State | TX
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Zip | 75149-6806
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Country | US
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Telephone | 855-782-7822
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Fax |
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Provider Business Mailing Address
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Address Line | 9850 ZENITH MERIDIAN DR APT 4-105
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City | ENGLEWOOD
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State | CO
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Zip | 80112-6309
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Country | US
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Telephone | 303-717-7813
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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 | 5896
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License Number State | TX
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