Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 2621 | TX |
NPI | 1063076107 |
---|---|
Provider Name | Chrisana Rebecca Calandro |
First Address | Pantego, TX 76013-3255 |
Second Address | Irving, TX 75063-2693 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2019 |
Last Update Date | 24/04/2019 |