East Texas Learning Lab

NPI #1194591768 in Henderson, Texas

Provider Information

NPI Number: 1194591768
Entity Type: Organization
Organization Name: East Texas Learning Lab
Primary Specialty: Behavior Analyst
Enumeration Date: Nov 27, 2023
Last Updated: Apr 30, 2025

Practice Location

Address: 1504 W MAIN ST
City: Henderson
State: Texas
ZIP Code: 75652-2836
Phone: (903) 918-3492

Authorized Official

Name: KRISTAL CLAY, CEO
Title: CEO/DIRECTOR
Phone: (903) 918-3492

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Early Intervention Provider Agency	252Y00000X
Clinic/Center - Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) — Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)	261QR0401X
Behavior Analyst	103K00000X	Primary

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