Provider Demographics
NPI:1992211924
Name:LAISSAOUI, KARINA MARIANA (BCBA)
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:MARIANA
Last Name:LAISSAOUI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:KARINA
Other - Middle Name:MARIANA
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:905 ROBERTS CUTOFF RD
Mailing Address - Street 2:
Mailing Address - City:RIVER OAKS
Mailing Address - State:TX
Mailing Address - Zip Code:76114-2825
Mailing Address - Country:US
Mailing Address - Phone:325-227-3885
Mailing Address - Fax:
Practice Address - Street 1:905 ROBERTS CUTOFF RD
Practice Address - Street 2:
Practice Address - City:RIVER OAKS
Practice Address - State:TX
Practice Address - Zip Code:76114-2825
Practice Address - Country:US
Practice Address - Phone:325-227-3885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-28
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
7157103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst