Provider Demographics
NPI:1568292175
Name:GUZMAN, MARIA DE LA LUZ (BCBA)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:DE LA LUZ
Last Name:GUZMAN
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 1:508 S AIRPORT DR
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6528
Mailing Address - Country:US
Mailing Address - Phone:956-733-5124
Mailing Address - Fax:
Practice Address - Street 1:4001 N MAYS ST STE 100
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-2735
Practice Address - Country:US
Practice Address - Phone:512-354-1820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-24-74506103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst