Healthcare Provider Details

I. General information

NPI: 1639997018
Provider Name (Legal Business Name): SYDNEY TETENS M.S., BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2024
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 KOHLERS XING STE 420
KYLE TX
78640-2463
US

IV. Provider business mailing address

115 KOHLERS XING STE 420
KYLE TX
78640-2463
US

V. Phone/Fax

Practice location:
  • Phone: 281-290-4411
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number010651
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: