Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 2553 | TX |
N | 106S00000X | Behavior Technician | RBT-16-27751 | TX |
NPI | 1003322488 |
---|---|
Provider Name | Lisa Robyn Lee |
First Address | Round Rock, TX 78665-5709 |
Second Address | Round Rock, TX 78665-5709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2017 |
Last Update Date | 25/01/2021 |