Provider Demographics
NPI:1437444775
Name:WISHKOSKI, ROBIN (BCBA)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:WISHKOSKI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11702 GRAY FOREST TRL
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-9311
Mailing Address - Country:US
Mailing Address - Phone:832-358-2655
Mailing Address - Fax:
Practice Address - Street 1:17810 SPRING CREEK FOREST DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-4290
Practice Address - Country:US
Practice Address - Phone:832-358-2655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst