Provider Demographics
NPI:1033007414
Name:GRANT, DEBORAH DENEASE (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:DENEASE
Last Name:GRANT
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:DENEASE
Other - Last Name:LUSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2154 COLLINS ALY
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-1896
Mailing Address - Country:US
Mailing Address - Phone:210-317-7012
Mailing Address - Fax:
Practice Address - Street 1:6801 JEFFERSON ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4379
Practice Address - Country:US
Practice Address - Phone:505-738-5906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8589103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst