MEDICARE: BRIANNA NICOLE ARREDONDO

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
1	106S00000X	Behavior Technician	RBT-21-188065	TX

General Provider Information

NPI Number	:	1558003467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA NICOLE ARREDONDO

Provider Business Mailing Address
First Line	:	300 CONVENT ST STE 1330
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78205-1357
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	207 LOWE DR
Second Line	:
City	:	DEL RIO
State	:	TX
Zip	:	78840-3026
Country	:	US
Telephone Number	:	830-775-4504
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2022
Last Update Date	:	04/11/2022

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Directions to “ BRIANNA NICOLE ARREDONDO ” Practice Location

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