| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KEENA LUCINDIVINE PAGARAN MEDRANO | 1548932171 | 2024-06-09 |
Keena Lucindivine Pagaran Medrano is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1548932171. Registration indicates Keena Lucindivine Pagaran Medrano is a provider of services with a specialization in Behavioral Health & Social Service Providers, Behavior Technician (Behavior Technician, Behavioral Health & Social Service Providers) (Behavior Technician, ) (Behavioral Health & Social Service Providers, Behavior Technician) (Behavior Technician, Behavioral Health & Social Service Providers) (Behavior Technician, )
| Entity Type | Individual |
| Provider Name | Keena Lucindivine Pagaran Medrano |
| Other Provider Name | Mrs. Keena Lucindivine Medrano Wong |
| Practice Office Address | 700 MILAM ST STE 1300 HOUSTON, TX US |
| Practice Office Telephone | 8774182978 |
| Practice Office Fax | 8665002186 |
| Mailing Address | 225 CEDAR HILL ST STE 200 MARLBOROUGH, MA 017525900 US |
| Code | Practice | License No State |
|---|---|---|
| 106S00000X | Behavioral Health & Social Service Providers Behavior Technician Behavior Technician Behavioral Health & Social Service Providers Behavior Technician | |
| 106S00000X PRIMARY | Behavioral Health & Social Service Providers Behavior Technician Behavior Technician Behavioral Health & Social Service Providers Behavior Technician | RBT-21-164317
TX |