Provider Demographics
NPI:1154953941
Name:NAVARRO, JULLISA A (BCBA)
Entity type:Individual
Prefix:
First Name:JULLISA
Middle Name:A
Last Name:NAVARRO
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 1:207 ELMHURST
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-5981
Mailing Address - Country:US
Mailing Address - Phone:737-248-7042
Mailing Address - Fax:512-519-8781
Practice Address - Street 1:2000 N MAYS ST STE 113
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-2166
Practice Address - Country:US
Practice Address - Phone:512-994-4201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-10
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-23-70084103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst