Provider Demographics
NPI:1548679574
Name:MIGAN-GANDONOU HORR, JULYSE AIDA (BCBA)
Entity type:Individual
Prefix:DR
First Name:JULYSE
Middle Name:AIDA
Last Name:MIGAN-GANDONOU HORR
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:JULYSE
Other - Middle Name:AIDA
Other - Last Name:MIGAN-GANDONOU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:3403B GARDEN VILLA LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-6915
Mailing Address - Country:US
Mailing Address - Phone:855-832-6727
Mailing Address - Fax:772-675-9100
Practice Address - Street 1:3403B GARDEN VILLA LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-6915
Practice Address - Country:US
Practice Address - Phone:855-832-6727
Practice Address - Fax:772-675-9100
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-04
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBCBA1-14-10282103K00000X
TXLBA-2740103K00000X
TX1-14-10282103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst