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General NPI Number Information
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NPI Number | 1366830135
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Entity Type | Individual
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Provider Name | MCKINSIE OBLAD BCBA
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Gender | Female
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Dates
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Enumeration Date | 01/02/2015
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Last Update Date | 10/19/2020
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Provider Practice Location Address
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Address Line | 700 N SAINT MARYS ST STE 1400
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City | SAN ANTONIO
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State | TX
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Zip | 78205-3535
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Country | US
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Telephone | 801-673-2839
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Fax |
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Provider Business Mailing Address
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Address Line | 11138 HUEBNER OAKS APT 387
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City | SAN ANTONIO
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State | TX
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Zip | 78230-1278
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Country | US
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Telephone | 801-673-2839
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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 | 11728923
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License Number State | UT
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