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General NPI Number Information
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NPI Number | 1255751863
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Entity Type | Organization
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Legal Business Name | AUTISM SPECTRUM INSTRUCTIONAL RESOURCES
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Dates
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Enumeration Date | 04/22/2014
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Last Update Date | 04/22/2014
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Provider Practice Location Address
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Address Line | 13405 SADDLE BACK PASS
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City | AUSTIN
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State | TX
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Zip | 78738-6149
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Country | US
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Telephone | 512-423-3225
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Fax |
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Provider Business Mailing Address
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Address Line | 4415 AVENUE B APT 104
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City | AUSTIN
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State | TX
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Zip | 78751-3629
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Country | US
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Telephone | 858-449-3463
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Fax |
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Authorized Official
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Title or Position | BEHAVIOR ANALYST
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Name | CAYENNE SHPALL
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Credential | M.ED., BCBA
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Telephone | 858-449-3463
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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 | 1-14-15555
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License Number State | TX
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