Provider Demographics
NPI:1568866432
Name:RICHARDSON, AMY (BCBA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:RICHARDSON
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 1:7435 HIGHWAY 6 STE F
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-5135
Mailing Address - Country:US
Mailing Address - Phone:832-539-1289
Mailing Address - Fax:832-539-6271
Practice Address - Street 1:7435 HIGHWAY 6 STE F
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-5135
Practice Address - Country:US
Practice Address - Phone:832-539-1289
Practice Address - Fax:281-713-8938
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1591103K00000X
TX1-14-10066103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst