Provider Demographics
NPI:1245614361
Name:GARMAN, DORETHA (BCBA)
Entity Type:Individual
Prefix:
First Name:DORETHA
Middle Name:
Last Name:GARMAN
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 1:450 CENTURY PKWY STE 250F
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-8136
Mailing Address - Country:US
Mailing Address - Phone:214-679-7001
Mailing Address - Fax:
Practice Address - Street 1:4601 BRIGHTON DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-8678
Practice Address - Country:US
Practice Address - Phone:214-679-7001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-18
Last Update Date:2022-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1106103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst