Idt Enterprise LLC

NPI #1396422036 in Desoto, Texas

Provider Information

NPI Number: 1396422036
Entity Type: Organization
Organization Name: Idt Enterprise LLC
Primary Specialty: Behavior Analyst
Enumeration Date: Jul 4, 2023
Last Updated: Oct 31, 2023

Practice Location

Address: 1510 N HAMPTON RD STE 150
City: Desoto
State: Texas
ZIP Code: 75115-8324
Phone: (682) 201-7934

Authorized Official

Name: TELEMA NGA
Title: CEO
Phone: (682) 201-7934

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Occupational Medicine — Occupational Medicine	261QX0100X
Behavior Analyst	103K00000X	Primary

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