Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 4197 | TX |
NPI | 1003324732 |
---|---|
Provider Name | Meagan Burgart |
First Address | Temple, TX 76502-4079 |
Second Address | Killeen, TX 76542-1312 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2018 |
Last Update Date | 24/06/2021 |