Basic Information
Provider Information
NPI: 1619503471
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOELSCHER
FirstName: KELSEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: BCBA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7500 SAN FELIPE ST STE 990
Address2:  
City: HOUSTON
State: TX
PostalCode: 770631708
CountryCode: US
TelephoneNumber: 2818263382
FaxNumber:  
Practice Location
Address1: 312 S 4TH ST
Address2:  
City: WACO
State: TX
PostalCode: 767012227
CountryCode: US
TelephoneNumber: 2547523451
FaxNumber: 2547563133
Other Information
ProviderEnumerationDate: 03/12/2020
LastUpdateDate: 07/20/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/20/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103K00000X1-21-51131TXY Behavioral Health & Social Service ProvidersBehavioral Analyst 

No ID Information.


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