Basic Information
| Provider Information | |||||||||
| NPI: | 1881163582 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BABANTO | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | CENIZA | ||||||||
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| Credential: | BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15810 PILGRIM HALL DRIVE | ||||||||
| Address2: | |||||||||
| City: | FRIENDSWOOD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77546 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8328670228 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1001 PINELOCH DRIVE | ||||||||
| Address2: | SUITE 600 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77062 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814616888 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/26/2018 | ||||||||
| LastUpdateDate: | 02/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106E00000X | 2566 | TX | N | 103K00000X | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.