Provider Demographics
NPI:1659654234
Name:SOLIZ, CHRISTIE ANN (MED BCBA)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:ANN
Last Name:SOLIZ
Suffix:
Gender:F
Credentials:MED BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6502 NURSERY DR.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904
Mailing Address - Country:US
Mailing Address - Phone:361-575-0611
Mailing Address - Fax:361-575-0626
Practice Address - Street 1:6502 NURSERY DR.
Practice Address - Street 2:SUITE 100
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904
Practice Address - Country:US
Practice Address - Phone:361-575-0611
Practice Address - Fax:361-575-0626
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1107618103K00000X
TX1-10-7618103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst