Basic Information
| Provider Information | |||||||||
| NPI: | 1558933069 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HEBERT | ||||||||
| FirstName: | KADEE | ||||||||
| MiddleName: | LOREN | ||||||||
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| Credential: | M.ED, BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18319 LODGEPOLE PINE ST | ||||||||
| Address2: | |||||||||
| City: | CYPRESS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774295236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4324887763 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4540 SPRING STUEBNER RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | SPRING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773891116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8557827822 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2021 | ||||||||
| LastUpdateDate: | 07/14/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 1-21-51475 | TX | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.