Provider Demographics
NPI:1083203038
Name:KACZMARSKI, AIMEE CHRISTINA (RBT)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:CHRISTINA
Last Name:KACZMARSKI
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 1:245 FM 1488 RD APT 2207
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-3959
Mailing Address - Country:US
Mailing Address - Phone:832-803-3878
Mailing Address - Fax:
Practice Address - Street 1:16835 DEER CREEK DR STE 200
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-4895
Practice Address - Country:US
Practice Address - Phone:281-379-4373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician