NPI 1003492745

Phoenix Gray

Practitioner Behavior Technician Pearland, TX

Practice location

Address: 6516 Broadway St Suite 112, Pearland, TX 77581-7880
Phone: (303) 989-8169

Registered specialties

Behavior Technician Primary

Behavioral Health & Social Service Providers Taxonomy 106S00000X

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Registry record

NPI: 1003492745
Entity type: Individual
Sex (as registered): Female
NPI issued: 23 Mar 2021
Record last updated: 23 Mar 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.