Provider Demographics
NPI:1265762041
Name:AUTISM CENTRAL THERAPY, PLLC.
Entity type:Organization
Organization Name:AUTISM CENTRAL THERAPY, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GENARLSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP, BCBA
Authorized Official - Phone:254-722-5236
Mailing Address - Street 1:143 ELCO LN
Mailing Address - Street 2:
Mailing Address - City:CHINA SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:76633-3080
Mailing Address - Country:US
Mailing Address - Phone:254-722-5236
Mailing Address - Fax:254-836-0690
Practice Address - Street 1:143 ELCO LN
Practice Address - Street 2:
Practice Address - City:CHINA SPRING
Practice Address - State:TX
Practice Address - Zip Code:76633-3080
Practice Address - Country:US
Practice Address - Phone:254-722-5236
Practice Address - Fax:254-836-0690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-30
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-09-5269103K00000X
TX18196235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty