Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-04-1778 | TX |
NPI | 1003118605 |
---|---|
Provider Name | Mrs. Catriona Cullum |
First Address | Houston, TX 77098 |
Second Address | Houston, TX 77098 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2010 |
Last Update Date | 02/12/2010 |