Provider Demographics
NPI:1265102230
Name:CLOUSER, EDWARD MARSHALL JR (BCBA, LBA)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:MARSHALL
Last Name:CLOUSER
Suffix:JR
Gender:M
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11522 ENDICOTT LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-2914
Mailing Address - Country:US
Mailing Address - Phone:281-777-4635
Mailing Address - Fax:
Practice Address - Street 1:11522 ENDICOTT LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-2914
Practice Address - Country:US
Practice Address - Phone:281-777-4635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1887103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst