Provider Demographics
NPI:1912499450
Name:KAUFMAN, MARY CLAIRE (RBT)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:CLAIRE
Last Name:KAUFMAN
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 ELMHURST
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-5981
Mailing Address - Country:US
Mailing Address - Phone:737-248-7042
Mailing Address - Fax:
Practice Address - Street 1:207 ELMHURST
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-5981
Practice Address - Country:US
Practice Address - Phone:737-248-7042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
TX1-18-33947103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician