Providence Lively, BCBA, LBA

NPI #1629726948 in Irving, Texas

Provider Information

NPI Number: 1629726948
Entity Type: Individual
Name: Providence Lively, BCBA, LBA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Analyst
Credential: BCBA, LBA
Enumeration Date: Mar 15, 2022
Last Updated: Feb 20, 2025

Practice Location

Address: 400 E ROYAL LN STE 290
City: Irving
State: Texas
ZIP Code: 75039-3602
Phone: (855) 832-6727

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Assistant Behavior Analyst	106E00000X
Behavior Analyst	103K00000X	Primary

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