Provider Demographics
NPI:1003329723
Name:SARLI, GARY GENE (BCBA, LPA)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:GENE
Last Name:SARLI
Suffix:
Gender:M
Credentials:BCBA, LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19965 FM 3175
Mailing Address - Street 2:
Mailing Address - City:LYTLE
Mailing Address - State:TX
Mailing Address - Zip Code:78052-3481
Mailing Address - Country:US
Mailing Address - Phone:830-266-5480
Mailing Address - Fax:830-772-4350
Practice Address - Street 1:19965 FM 3175
Practice Address - Street 2:
Practice Address - City:LYTLE
Practice Address - State:TX
Practice Address - Zip Code:78052-3481
Practice Address - Country:US
Practice Address - Phone:830-266-5480
Practice Address - Fax:830-772-4350
Is Sole Proprietor?:No
Enumeration Date:2017-11-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-14-9447103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst