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General NPI Number Information
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NPI Number | 1184329559
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Entity Type | Individual
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Provider Name | ANDREW JOHN BENNETT B.A., BCABA
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Gender | Male
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Dates
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Enumeration Date | 04/04/2023
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 121 VISION PARK BLVD STE 250
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City | SHENANDOAH
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State | TX
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Zip | 77384-3028
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Country | US
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Telephone | 346-200-5618
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Fax |
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Provider Business Mailing Address
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Address Line | 6914 BRISBANE CT STE 200
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City | SUGAR LAND
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State | TX
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Zip | 77479-4924
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Country | US
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Telephone | 844-272-7223
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 5830
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License Number State | TX
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