Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-21-12466 | TX |
NPI | 1033882436 |
---|---|
Provider Name | Ms. Hailey Hewatt |
First Address | League City, TX 77573-2371 |
Second Address | Houston, TX 77021-5403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2021 |
Last Update Date | 30/07/2021 |