Provider Demographics
NPI:1205369782
Name:ALANIZ, LETICIA GERALDINE (BCABA)
Entity Type:Individual
Prefix:
First Name:LETICIA
Middle Name:GERALDINE
Last Name:ALANIZ
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 N SNAPPER DR
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-0042
Mailing Address - Country:US
Mailing Address - Phone:956-437-7722
Mailing Address - Fax:
Practice Address - Street 1:1821 N SNAPPER DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78541-0042
Practice Address - Country:US
Practice Address - Phone:956-437-7722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0-17-7654106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst