Ealy, Danita Wallace

Ealy, Danita Wallace is an sole proprietor health care provider with primary practice located at 14090 Southwest Fwy Suite 300 #788, Sugar Land TX 77478-2210. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavioral Analyst, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Ealy, Danita Wallace can be contacted via phone (213) 293-4393.

Contact Information

Primary practice address
14090 Southwest Fwy Suite 300 #788 Sugar Land TX 77478-2210
Phone: (213) 293-4393
Fax: (346) 699-0169
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-16-22409 Texas
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-1622409 Oklahoma
Behavioral Health & Social Service Providers / Psychologist 103T00000X 37235 Texas
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1322 Texas

Profile Details

NPI number 1215388558
LBN Legal business name Ealy, Danita Wallace
Credentials MS, LPA, BCBA, LBA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 28th, 2016
Last updated Nov 24th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215388558 NPPES
Texas MEDICAID 432112701

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