Provider Demographics
NPI:1609372507
Name:HUSSAIN, KIRAN (BCBA)
Entity Type:Individual
Prefix:
First Name:KIRAN
Middle Name:
Last Name:HUSSAIN
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 1:5757 BERNAY LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2905
Mailing Address - Country:US
Mailing Address - Phone:469-371-2988
Mailing Address - Fax:
Practice Address - Street 1:5757 BERNAY LN
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2905
Practice Address - Country:US
Practice Address - Phone:469-371-2988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-01
Last Update Date:2019-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2828103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst