Provider Demographics
NPI:1346910411
Name:VEGA, PAULINA (BCBA)
Entity Type:Individual
Prefix:
First Name:PAULINA
Middle Name:
Last Name:VEGA
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 1:1220 N ALMA DR STE 110
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-4624
Mailing Address - Country:US
Mailing Address - Phone:469-730-0925
Mailing Address - Fax:972-497-2012
Practice Address - Street 1:1220 N ALMA DR STE 110
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-4624
Practice Address - Country:US
Practice Address - Phone:469-730-0925
Practice Address - Fax:972-497-2012
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst