Provider Demographics
NPI:1932929775
Name:KIRIS, CASSIDY (MS, BCBA)
Entity type:Individual
Prefix:
First Name:CASSIDY
Middle Name:
Last Name:KIRIS
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12621 HERO WAY W BUILDING A
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641
Mailing Address - Country:US
Mailing Address - Phone:737-273-7299
Mailing Address - Fax:
Practice Address - Street 1:12621 HERO WAY W BUILDING A
Practice Address - Street 2:SUITE 2
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641
Practice Address - Country:US
Practice Address - Phone:737-273-7299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst