Provider Demographics
NPI:1184067621
Name:DRACOBLY, JOSEPH (PHD, BCBA-D, LBA)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:DRACOBLY
Suffix:
Gender:M
Credentials:PHD, BCBA-D, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 UNION CIR # 310919
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76203-5017
Mailing Address - Country:US
Mailing Address - Phone:940-565-4826
Mailing Address - Fax:
Practice Address - Street 1:1155 UNION CIR
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76203-5017
Practice Address - Country:US
Practice Address - Phone:940-565-4826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-10-6834103K00000X
TX2403103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-10-6834OtherBCBA
TX2403OtherLICENSED BEHAVIOR ANALYST