Provider Demographics
NPI:1407328255
Name:CAIN, HANNA M (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:HANNA
Middle Name:M
Last Name:CAIN
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 1:136 E CONCHO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76903-5947
Mailing Address - Country:US
Mailing Address - Phone:325-777-2727
Mailing Address - Fax:325-777-2737
Practice Address - Street 1:136 E CONCHO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-5947
Practice Address - Country:US
Practice Address - Phone:325-777-2727
Practice Address - Fax:325-777-2737
Is Sole Proprietor?:No
Enumeration Date:2018-12-18
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-15-05390106S00000X
TX3053103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1-19-38354OtherBEHAVIOR ANALYST CERTIFICATION BOARD