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General NPI Number Information
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NPI Number | 1467257808
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Entity Type | Organization
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Legal Business Name | BRIGHT MINDS THERAPY
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Dates
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Enumeration Date | 02/18/2025
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 5900 BALCONES DR STE 100
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City | AUSTIN
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State | TX
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Zip | 78731-4298
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Country | US
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Telephone | 469-382-6488
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Fax |
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Provider Business Mailing Address
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Address Line | 5900 BALCONES DR STE 100
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City | AUSTIN
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State | TX
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Zip | 78731-4298
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF CLINICAL OFFICER
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Name | ALEEZA MOHAMMED
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Credential | BCBA
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Telephone | 469-867-7892
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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