Healthcare Provider Details

I. General information

NPI: 1164342374
Provider Name (Legal Business Name): SKILLBRIDGE ABA THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2402 VALLEY VIEW DR
CEDAR HILL TX
75104-6710
US

IV. Provider business mailing address

2402 VALLEY VIEW DR
CEDAR HILL TX
75104-6710
US

V. Phone/Fax

Practice location:
  • Phone: 817-520-4647
  • Fax: 817-520-4648
Mailing address:
  • Phone: 719-627-7817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: ANNETTE OKONOFUA
Title or Position: BCBA/OWNER
Credential: BCBA
Phone: 719-627-7817