Provider Demographics
NPI:1386231694
Name:CUELLAR, MAYA KRISTINA (BCBA)
Entity type:Individual
Prefix:MS
First Name:MAYA
Middle Name:KRISTINA
Last Name:CUELLAR
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 1:2709 CRYSTAL FALLS DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-2847
Mailing Address - Country:US
Mailing Address - Phone:214-493-2228
Mailing Address - Fax:
Practice Address - Street 1:4105 W SPRING CREEK PKWY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-5283
Practice Address - Country:US
Practice Address - Phone:972-596-0035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3786103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst