Provider Demographics
NPI:1568156875
Name:LUCE, BRIDGETTE ARLENE (LBA, BCBA)
Entity Type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:ARLENE
Last Name:LUCE
Suffix:
Gender:F
Credentials:LBA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 36
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:TX
Mailing Address - Zip Code:77836-0036
Mailing Address - Country:US
Mailing Address - Phone:979-406-2041
Mailing Address - Fax:
Practice Address - Street 1:4001 HIGHWAY 36 S
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-9610
Practice Address - Country:US
Practice Address - Phone:979-406-2041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3266103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst