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General NPI Number Information
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NPI Number | 1114741311
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Entity Type | Organization
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Legal Business Name | MIGRATION BY BLUEBIRD
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 6506 MARBLEWOOD DR
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City | AUSTIN
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State | TX
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Zip | 78731-1745
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Country | US
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Telephone | 512-827-9537
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Fax |
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Provider Business Mailing Address
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Address Line | 7700 NORTHCROSS DR # 49283
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City | AUSTIN
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State | TX
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Zip | 78757-1715
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Country | US
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Telephone | 512-827-9537
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | LAUREN BROOKE PFEIFFER
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Credential | BCBA, LBA
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Telephone | 512-827-9537
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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 |
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License Number State |
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