Provider Demographics
NPI:1821682170
Name:CERDA, MARI-LUCI (BCBA, LBA-TX)
Entity Type:Individual
Prefix:DR
First Name:MARI-LUCI
Middle Name:
Last Name:CERDA
Suffix:
Gender:F
Credentials:BCBA, LBA-TX
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2824 25TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-2216
Mailing Address - Country:US
Mailing Address - Phone:979-323-4352
Mailing Address - Fax:
Practice Address - Street 1:5502 58TH ST STE 500
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79414-2087
Practice Address - Country:US
Practice Address - Phone:806-703-4379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-26
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3087103K00000X
TX11937973103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst