Provider Demographics
NPI:1003340233
Name:PRICE, KAYLEE KRISTINE (BCBA)
Entity Type:Individual
Prefix:
First Name:KAYLEE
Middle Name:KRISTINE
Last Name:PRICE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 S INTERSTATE 35
Mailing Address - Street 2:912
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-6605
Mailing Address - Country:US
Mailing Address - Phone:936-828-7062
Mailing Address - Fax:
Practice Address - Street 1:7500 S INTERSTATE 35
Practice Address - Street 2:912
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-6605
Practice Address - Country:US
Practice Address - Phone:936-828-7062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-14
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-17-25749103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst