Provider Demographics
NPI:1992230916
Name:MOLINA, ELVIRA ELIZABETH (BCBA)
Entity type:Individual
Prefix:
First Name:ELVIRA
Middle Name:ELIZABETH
Last Name:MOLINA
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 1:16835 DEER CREEK DR STE 220
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-4895
Mailing Address - Country:US
Mailing Address - Phone:281-664-1990
Mailing Address - Fax:281-664-1991
Practice Address - Street 1:12407 HYMEADOW DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1818
Practice Address - Country:US
Practice Address - Phone:281-664-1990
Practice Address - Fax:281-664-1991
Is Sole Proprietor?:No
Enumeration Date:2017-04-27
Last Update Date:2022-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106E00000X
CA1-20-45119103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst