Provider Demographics
NPI:1891358339
Name:LUKE, MAYUMI CRISTINA (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:MAYUMI
Middle Name:CRISTINA
Last Name:LUKE
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:MAYUMI
Other - Middle Name:CRISTINA
Other - Last Name:CERVANTES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1007 CONCHO ST
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-3792
Mailing Address - Country:US
Mailing Address - Phone:254-422-4825
Mailing Address - Fax:
Practice Address - Street 1:4003 W STAN SCHLUETER LOOP
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-6119
Practice Address - Country:US
Practice Address - Phone:818-345-2345
Practice Address - Fax:254-213-1705
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
TX5963103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7131995555OtherNA
7131995555OtherNA