Provider Demographics
NPI:1629566815
Name:COOK, KAHLA D (RBT)
Entity Type:Individual
Prefix:
First Name:KAHLA
Middle Name:D
Last Name:COOK
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11250 MASON RD APT 4118
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-8066
Mailing Address - Country:US
Mailing Address - Phone:281-894-1423
Mailing Address - Fax:832-298-7833
Practice Address - Street 1:11820 CYPRESS CORNER LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-1132
Practice Address - Country:US
Practice Address - Phone:281-894-1423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-24
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
TX4980103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-22-58946OtherBEHAVIOR ANALYST CERTIFICATION BOARD