Provider Demographics
NPI:1942880109
Name:HARRIS, CRAIG DANIEL I (RBT)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:DANIEL
Last Name:HARRIS
Suffix:I
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9901 N CAPITAL OF TEXAS HWY STE 250
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5977
Mailing Address - Country:US
Mailing Address - Phone:512-887-2126
Mailing Address - Fax:
Practice Address - Street 1:2500 W WILLIAM CANNON DR # 704
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5257
Practice Address - Country:US
Practice Address - Phone:512-920-0335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician