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General NPI Number Information
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NPI Number | 1992364376
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Entity Type | Individual
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Provider Name | DIANA VALERIA ANZURES PUGA MA, BCBA
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Gender | Female
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Dates
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Enumeration Date | 06/10/2019
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 8219 NORTHBRIDGE DR
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City | SPRING
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State | TX
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Zip | 77379-4523
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Country | US
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Telephone | 832-740-5224
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Fax |
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Provider Business Mailing Address
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Address Line | 15703 LONGENBAUGH DR SUITE H
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City | HOUSTON
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State | TX
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Zip | 77095-1605
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Country | US
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Telephone |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-22-61337
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License Number State | TX
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