Most Relevant Information
Provider Data
| NPI Number: | 1003541152 |
| Provider Name: | BAHATI KIMONDO |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-16-15039 |
Most Important Dates
| Enumeration Date: | 07/22/2022 |
| Last Updated: | 07/22/2022 |
Provider Practice Location
2104 GREENBRIAR DR
SOUTHLAKE
TX
760928355
Practice Location Phone/Fax
| Phone: | 8174429022 |
| Fax: |
Provider Mailing Location
2104 GREENBRIAR DR
SOUTHLAKE
TX
760928355
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |