Provider Demographics
NPI:1073123147
Name:FERNANDEZ, BEATRIZ ADRIANA (RBT)
Entity Type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:ADRIANA
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 COUNTY ROAD 911
Mailing Address - Street 2:
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189-7283
Mailing Address - Country:US
Mailing Address - Phone:469-625-7842
Mailing Address - Fax:
Practice Address - Street 1:8408 STACY RD STE 300
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-2422
Practice Address - Country:US
Practice Address - Phone:469-625-2193
Practice Address - Fax:469-998-2193
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-19-91463106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician