Provider Demographics
NPI:1407232788
Name:OMSBERG, AMY ELIZABETH (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:OMSBERG
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Gender:F
Credentials:BCBA, LBA
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Mailing Address - Street 1:305 NE LOOP 820
Mailing Address - Street 2:BUSINESS TOWER 1, SUITE 200
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053-7209
Mailing Address - Country:US
Mailing Address - Phone:817-282-8787
Mailing Address - Fax:817-789-6849
Practice Address - Street 1:2700 EARL RUDDER FWY S
Practice Address - Street 2:SUITE1200
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-5010
Practice Address - Country:US
Practice Address - Phone:979-307-5850
Practice Address - Fax:855-380-4004
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-10
Last Update Date:2020-10-15
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Provider Licenses
StateLicense IDTaxonomies
TX1-20-41584103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst