Provider Demographics
NPI:1396336988
Name:BAPTISTE, MARIAH (BS)
Entity type:Individual
Prefix:
First Name:MARIAH
Middle Name:
Last Name:BAPTISTE
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3806 W MAGNOLIA DALE DR
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-8673
Mailing Address - Country:US
Mailing Address - Phone:832-704-5344
Mailing Address - Fax:
Practice Address - Street 1:7435 HIGHWAY 6 STE F
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-5135
Practice Address - Country:US
Practice Address - Phone:281-713-8980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1866531106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician