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General NPI Number Information
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NPI Number | 1447667530
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Entity Type | Organization
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Legal Business Name | ADVANCED BEHAVIORAL INTERVENTIONS
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Dates
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Enumeration Date | 07/21/2014
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Last Update Date | 07/21/2014
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Provider Practice Location Address
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Address Line | 7113 SAN PEDRO AVE # 184
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City | SAN ANTONIO
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State | TX
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Zip | 78216-6219
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Country | US
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Telephone | 210-264-7053
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Fax | 210-257-8399
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Provider Business Mailing Address
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Address Line | 7113 SAN PEDRO AVE # 184
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City | SAN ANTONIO
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State | TX
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Zip | 78216-6219
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Country | US
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Telephone | 210-264-7053
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Fax | 210-257-8399
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Authorized Official
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Title or Position | BEHAVIORAL ANALYST AND CONSULTANT
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Name | MRS. STEFANI LYNN BACHMEIER CLEMMER
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Credential | BCBA
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Telephone | 210-264-7053
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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 | 1-11-9044
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License Number State | TX
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