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General NPI Number Information
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NPI Number | 1114417748
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Entity Type | Individual
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Provider Name | KIANA JADE WHITLOCK MA, BCBA, LBA
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Gender | Female
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Dates
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Enumeration Date | 05/18/2018
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 24870 BLANCO RD
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City | SAN ANTONIO
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State | TX
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Zip | 78260-6674
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Country | US
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Telephone | 210-756-8586
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Fax |
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Provider Business Mailing Address
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Address Line | 5650 WORTH PKWY APT 2426
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City | SAN ANTONIO
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State | TX
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Zip | 78257-1516
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Country | US
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Telephone | 210-935-2707
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 5579
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License Number State | TX
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