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General NPI Number Information
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NPI Number | 1356595904
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Entity Type | Organization
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Legal Business Name | AUTISM SPECTRUM INSTRUCTIONAL RESOURCES, LLC
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Dates
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Enumeration Date | 11/10/2008
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Last Update Date | 11/10/2008
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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 | 512-656-1835
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Fax | 512-263-5866
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Provider Business Mailing 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 | 512-656-1835
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Fax | 512-263-5866
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. ALLISON ANN GOURIS
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Credential | M.ED., BCBA
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Telephone | 512-656-1835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1-05-2554
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License Number State | TX
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