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NPI Code Detail

MEDICARE: MARIANA LEE ACEVEDO

MEDICARE: MARIANA LEE ACEVEDO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1205765518
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIANA LEE ACEVEDO
Provider Business Mailing Address
First Line : 12000 NETWORK BLVD STE 210
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78249-3353
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 17319 SAN PEDRO AVE STE 510
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78232-1444
Country : US
Telephone Number : 888-611-0870
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2026
Last Update Date : 05/14/2026

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Directions to “ MARIANA LEE ACEVEDO ” Practice Location

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