Most Relevant Information
Provider Data
| NPI Number: | 1003492075 |
| Provider Name: | LAVISHA CHARLES RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-21-160281 |
Most Important Dates
| Enumeration Date: | 03/22/2021 |
| Last Updated: | 03/22/2021 |
Provider Practice Location
4910 AIRPORT AVE STE F
ROSENBERG
TX
774715759
Practice Location Phone/Fax
| Phone: | 2812391428 |
| Fax: | 2812390828 |
Provider Mailing Location
4910 AIRPORT AVE STE D
ROSENBERG
TX
774715759
Provider Mailing Phone/Fax
| Phone: | 2812391445 |
| Fax: | 2812390828 |