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NPI Code Detail

MEDICARE: ANNETT L ALLEN BCBA

MEDICARE: ANNETT L ALLEN BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior AnalystTX

General Provider Information

NPI Number : 1073817763
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNETT L ALLEN BCBA
Provider Business Mailing Address
First Line : 17810 SPRING CREEK FOREST DR
Second Line :
City : SPRING
State : TX
Zip : 77379
Country : US
Telephone Number : 832-358-2655
Fax Number :
Provider Business Practice Location Address
First Line : 17810 SPRING CREEK FOREST DR
Second Line :
City : SPRING
State : TX
Zip : 77379-4290
Country : US
Telephone Number : 832-358-2655
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2011
Last Update Date : 01/09/2017

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