| Changing The Spectrum, Llc | |
|
4210 Broadway St Pearland TX 77581-4118 | |
| (281) 676-2557 | |
| (318) 855-1277 |
| Full Name | Changing The Spectrum, Llc |
|---|---|
| Speciality | Early Intervention Provider Agency |
| Location | 4210 Broadway St, Pearland, Texas |
| Authorized Official Name and Position | Victoria Johnson (OWNER, BCBA) |
| Authorized Official Contact | 3186806422 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Changing The Spectrum, Llc 3411 Whitman Dr Rosharon TX 77583-1204 Ph: (318) 680-6422 | Changing The Spectrum, Llc 4210 Broadway St Pearland TX 77581-4118 Ph: (281) 676-2557 |
| NPI Number | 1174087431 |
|---|---|
| Provider Enumeration Date | 01/30/2019 |
| Last Update Date | 11/10/2023 |
| Certification Date | 11/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174087431 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 252Y00000X | Early Intervention Provider Agency | (* (Not Available)) | Primary |
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