Bouagnan Johann Pitah

NPI #1043838931 in Southlake, Texas

Provider Information

NPI Number: 1043838931
Entity Type: Individual
Name: Bouagnan Johann Pitah
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Jul 8, 2020
Last Updated: Jul 8, 2020

Practice Location

Address: 2425 E SOUTHLAKE BLVD
City: Southlake
State: Texas
ZIP Code: 76092-6674
Phone: (817) 442-0222

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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