Provider Demographics
NPI:1477956977
Name:COBB, SCOUT (BCBA)
Entity Type:Individual
Prefix:
First Name:SCOUT
Middle Name:
Last Name:COBB
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 1:10718 RADIANT REALM DR
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-0083
Mailing Address - Country:US
Mailing Address - Phone:832-335-8827
Mailing Address - Fax:
Practice Address - Street 1:10718 RADIANT REALM DR
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-0083
Practice Address - Country:US
Practice Address - Phone:832-335-8827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-29
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-14-9511103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst