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General NPI Number Information
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NPI Number | 1881389039
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Entity Type | Organization
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Legal Business Name | CHOICES BEHAVIORAL HEALTH OF EAST TX, PLLC
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Dates
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Enumeration Date | 04/05/2023
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Last Update Date | 04/05/2023
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Provider Practice Location Address
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Address Line | 914 S MEADOWS DR
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City | DIBOLL
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State | TX
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Zip | 75941-2805
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Country | US
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Telephone | 936-671-2061
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Fax |
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Provider Business Mailing Address
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Address Line | 914 S MEADOWS DR
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City | DIBOLL
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State | TX
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Zip | 75941-2805
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Country | US
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Telephone | 936-671-2061
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Fax |
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Authorized Official
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Title or Position | OWNER BEHAVIOR ANALYST AND COUNSELO
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Name | ROBIN L MCKNIGHT
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Credential | BCBA, LBA, LPC
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Telephone | 936-671-2061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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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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