Provider Demographics
NPI:1376932632
Name:CONNER, CHRISTINA (BCBA)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:CONNER
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 1:16103 PEACH BLUFF LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-5707
Mailing Address - Country:US
Mailing Address - Phone:832-677-2990
Mailing Address - Fax:
Practice Address - Street 1:16103 PEACH BLUFF LN
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-5707
Practice Address - Country:US
Practice Address - Phone:832-677-2990
Practice Address - Fax:832-677-2990
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-09
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11212290103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst