Healthcare Provider Details

I. General information

NPI: 1679334965
Provider Name (Legal Business Name): AUDREY FIELDS BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2024
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5209 DUVAL RD
AUSTIN TX
78727-6614
US

IV. Provider business mailing address

5217 OLD SPICEWOOD SPRINGS RD APT 1709
AUSTIN TX
78731-1031
US

V. Phone/Fax

Practice location:
  • Phone: 512-250-5700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-78298
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number22-214274
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: