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General NPI Number Information
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NPI Number | 1285300236
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL HEALTH FUNDAMENTALS PLLC
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Dates
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Enumeration Date | 08/19/2021
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Last Update Date | 03/14/2023
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Provider Practice Location Address
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Address Line | 255 MEADOW GLADE DR
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City | SAN ANTONIO
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State | TX
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Zip | 78227-1005
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Country | US
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Telephone | 210-528-0699
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Fax |
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Provider Business Mailing Address
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Address Line | 255 MEADOW GLADE DR
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City | SAN ANTONIO
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State | TX
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Zip | 78227-1005
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Country | US
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Telephone | 210-528-0699
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Fax |
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Authorized Official
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Title or Position | OWNER/ BCBA / DOCTOR
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Name | DR. BRANDI J DUKE
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Credential | BCBA, PHD
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Telephone | 210-844-9469
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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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