Active NPI
Gloria Nicole Maillard, MS, BCBA, LBA
- Behavior Analyst
- The Colony, TX
National Provider Identifier
1346852134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 2184
- Practice address
- 5505 Liberty Dr
The Colony, TX 75056-3741 - Phone
- (707) 718-5581
- NPI assigned
- Aug 21, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 2184 | TX | Primary |
Addresses
Primary practice location
5505 Liberty Dr
The Colony, TX 75056-3741
Mailing address
5505 Liberty Dr
The Colony, TX 75056-3741
Phone (707) 718-5581
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2184 | TX | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597968000000",
"number": "1346852134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5505 LIBERTY DR",
"city": "THE COLONY",
"state": "TX",
"postal_code": "750563741",
"telephone_number": "707-718-5581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5505 LIBERTY DR",
"city": "THE COLONY",
"state": "TX",
"postal_code": "750563741",
"telephone_number": "707-718-5581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAILLARD",
"first_name": "GLORIA",
"middle_name": "NICOLE",
"name_prefix": "Miss",
"credential": "MS, BCBA, LBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-21",
"last_updated": "2020-08-21",
"certification_date": "2020-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": "2184",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in The Colony, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.