Provider Demographics
NPI:1376973339
Name:MULDER, ADRIANA CLASINA (MBA, MS, BCABA)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:CLASINA
Last Name:MULDER
Suffix:
Gender:F
Credentials:MBA, MS, BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12310 N SHADOW COVE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2504
Mailing Address - Country:US
Mailing Address - Phone:832-454-4845
Mailing Address - Fax:
Practice Address - Street 1:12310 N SHADOW COVE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2504
Practice Address - Country:US
Practice Address - Phone:832-454-4845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-12
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0-13-5671103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst