Provider Demographics
NPI:1215235593
Name:TOUSSAINT, KAREN A (PLP, BCBA-D)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:TOUSSAINT
Suffix:
Gender:F
Credentials:PLP, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 UNION CIR # 310919
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76203-5017
Mailing Address - Country:US
Mailing Address - Phone:940-369-5371
Mailing Address - Fax:940-565-2467
Practice Address - Street 1:410 AVENUE C
Practice Address - Street 2:360F CHILTON HALL
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201
Practice Address - Country:US
Practice Address - Phone:940-369-5371
Practice Address - Fax:940-565-2467
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-10
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE427103T00000X
NE1-12-10481103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025287200Medicaid