Provider Demographics
NPI:1790333250
Name:DUQUENOY-WILKS, COSETTE HOPE (BCBA 1-22-62790)
Entity Type:Individual
Prefix:
First Name:COSETTE
Middle Name:HOPE
Last Name:DUQUENOY-WILKS
Suffix:
Gender:F
Credentials:BCBA 1-22-62790
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9850 ZENITH MERIDIAN DR APT 4-105
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-6309
Mailing Address - Country:US
Mailing Address - Phone:303-717-7813
Mailing Address - Fax:
Practice Address - Street 1:920 HIGHWAY 352 STE 200
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-6806
Practice Address - Country:US
Practice Address - Phone:855-782-7822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-28
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5896103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst