Provider Demographics
NPI:1124416714
Name:WILLIAMSON, JAMIE MARIE (BCBA)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:MARIE
Last Name:WILLIAMSON
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 1:917 PIPE GATE
Mailing Address - Street 2:
Mailing Address - City:CIBOLO
Mailing Address - State:TX
Mailing Address - Zip Code:78108-4423
Mailing Address - Country:US
Mailing Address - Phone:512-665-4184
Mailing Address - Fax:
Practice Address - Street 1:917 PIPE GATE
Practice Address - Street 2:
Practice Address - City:CIBOLO
Practice Address - State:TX
Practice Address - Zip Code:78108-4423
Practice Address - Country:US
Practice Address - Phone:512-665-4184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-05
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-14-17903103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst