Latoya N Bush
Individual provider Active NPI Behavior Technician · Lindale, TX
NPI 1780346015 · NPPES record last updated Oct 13, 2021
Key facts
- NPI
- 1780346015
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 14623 FM 849
Lindale, TX 75771-2440 - Phone
- (430) 235-2089
- NPI assigned
- Oct 13, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lone Star Day Program | Current |
Accepting new patients |
Locations
14623 FM 849
Lindale, TX 75771
Phone (430) 235-2089
14864 County Road 433
Tyler, TX 75706
Phone (430) 235-2089
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
14623 FM 849
Lindale, TX 75771-2440
Mailing address
14864 County Road 433
Tyler, TX 75706-3206
Phone (430) 235-2089
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lead@bltcenter.net | Direct |
Other providers in Lindale, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.