Provider Demographics
NPI:1720767734
Name:MCLURE, DERIAN JOSEPH (RBT)
Entity Type:Individual
Prefix:
First Name:DERIAN
Middle Name:JOSEPH
Last Name:MCLURE
Suffix:
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 1:4600 N JOSEY LN APT 2822
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4616
Mailing Address - Country:US
Mailing Address - Phone:214-471-6028
Mailing Address - Fax:
Practice Address - Street 1:2825 VALLEY VIEW LN STE 100
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-4943
Practice Address - Country:US
Practice Address - Phone:214-736-8376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician