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General NPI Number Information
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NPI Number | 1174341044
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Entity Type | Individual
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Provider Name | AVA MAI GALLEGOS
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Gender | Female
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 24200 W INTERSTATE 10 STE 109
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City | SAN ANTONIO
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State | TX
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Zip | 78257-1150
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Country | US
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Telephone | 210-263-9443
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Fax |
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Provider Business Mailing Address
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Address Line | 1255 O HARA DR
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City | SAN ANTONIO
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State | TX
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Zip | 78251-4944
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Country | US
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Telephone | 210-540-0177
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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 |
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License Number State |
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