Provider Demographics
NPI:1114696325
Name:LADDAGA GAVIDIA, VALERIA (BCBA)
Entity Type:Individual
Prefix:
First Name:VALERIA
Middle Name:
Last Name:LADDAGA GAVIDIA
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 1:3235 HERITAGE TRAIL BLVD APT 3400
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-3336
Mailing Address - Country:US
Mailing Address - Phone:956-802-9173
Mailing Address - Fax:
Practice Address - Street 1:490 N I 35 E
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205
Practice Address - Country:US
Practice Address - Phone:956-802-9173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst