Provider Demographics
NPI:1326627241
Name:ODONNELL, DYLAN P (RBT)
Entity Type:Individual
Prefix:
First Name:DYLAN
Middle Name:P
Last Name:ODONNELL
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6640 ASCOT LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-6304
Mailing Address - Country:US
Mailing Address - Phone:214-507-8564
Mailing Address - Fax:
Practice Address - Street 1:5510 ABRAMS RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75214-2000
Practice Address - Country:US
Practice Address - Phone:469-906-6372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-07
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst