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General NPI Number Information
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NPI Number | 1083013296
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Entity Type | Organization
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Legal Business Name | BRIDGING BEHAVIORS
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Dates
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Enumeration Date | 08/14/2014
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Last Update Date | 08/14/2014
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Provider Practice Location Address
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Address Line | 2427 FACET OAK
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City | SAN ANTONIO
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State | TX
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Zip | 78232-2652
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Country | US
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Telephone | 210-314-1545
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Fax | 210-314-1545
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Provider Business Mailing Address
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Address Line | 2427 FACET OAK
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City | SAN ANTONIO
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State | TX
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Zip | 78232-2652
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Country | US
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Telephone | 210-314-1545
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Fax | 210-314-1545
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Authorized Official
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Title or Position | CO-OWNER
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Name | BEVERLY SMITH
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Credential |
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Telephone | 210-314-1545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-14-16062
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License Number State | TX
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