Provider Demographics
NPI:1174068530
Name:TRAN, THIN (MED, BCBA)
Entity type:Individual
Prefix:
First Name:THIN
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 S HIGHWAY 78 STE 123
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-4112
Mailing Address - Country:US
Mailing Address - Phone:972-746-6255
Mailing Address - Fax:
Practice Address - Street 1:429 KENNEWICK DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-3204
Practice Address - Country:US
Practice Address - Phone:469-386-5442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-21
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-16-24316103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst