Provider Demographics
NPI:1184495681
Name:BOUCHER, CINNAMON JOY (BCBA, LBA)
Entity type:Individual
Prefix:MRS
First Name:CINNAMON
Middle Name:JOY
Last Name:BOUCHER
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:CINNAMON
Other - Middle Name:JOY
Other - Last Name:SIMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:7500 SAN FELIPE ST STE 990
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-1708
Mailing Address - Country:US
Mailing Address - Phone:281-826-3382
Mailing Address - Fax:
Practice Address - Street 1:25925 BUDDE RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-2011
Practice Address - Country:US
Practice Address - Phone:281-465-4468
Practice Address - Fax:832-442-5334
Is Sole Proprietor?:No
Enumeration Date:2024-01-12
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6531103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst