Provider Demographics
NPI:1861870768
Name:JEFFERSON, TRANIKA LASHANN (BCBA-D)
Entity type:Individual
Prefix:DR
First Name:TRANIKA
Middle Name:LASHANN
Last Name:JEFFERSON
Suffix:
Gender:F
Credentials:BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9423 GRAND SPARK DR
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583-3375
Mailing Address - Country:US
Mailing Address - Phone:979-574-1984
Mailing Address - Fax:
Practice Address - Street 1:9423 GRAND SPARK DR
Practice Address - Street 2:
Practice Address - City:ROSHARON
Practice Address - State:TX
Practice Address - Zip Code:77583-3375
Practice Address - Country:US
Practice Address - Phone:979-574-1984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-12
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1015103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst