Provider Demographics
NPI:1720446990
Name:DALSING, MARY (BCBA)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:DALSING
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15230 MCKAYS LARK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-6502
Mailing Address - Country:US
Mailing Address - Phone:636-346-0337
Mailing Address - Fax:
Practice Address - Street 1:2343 PREAKNESS LN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-2512
Practice Address - Country:US
Practice Address - Phone:636-346-0337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-03
Last Update Date:2021-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3978103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst