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General NPI Number Information
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NPI Number | 1932805421
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Entity Type | Organization
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Legal Business Name | THE BEHAVIORAL WELLNESS ACADEMY, PLLC
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Dates
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Enumeration Date | 02/06/2023
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Last Update Date | 02/06/2023
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Provider Practice Location Address
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Address Line | 9423 GRAND SPARK DR
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City | ROSHARON
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State | TX
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Zip | 77583-3375
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Country | US
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Telephone | 979-574-1984
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Fax | 281-754-4320
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Provider Business Mailing Address
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Address Line | 9423 GRAND SPARK DR
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City | ROSHARON
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State | TX
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Zip | 77583-3375
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Country | US
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Telephone | 979-574-1984
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Fax | 281-754-4320
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Authorized Official
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Title or Position | OWNER
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Name | DR. TRANIKA LASHANN JEFFERSON
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Credential | PHD, BCBA-D, LBA
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Telephone | 979-574-1984
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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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