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NPI 1497456313

NPI 1497456313 : ABA AND BEHAVIORAL SUPPORTS, LLC : SAN ANTONIO, TX

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General NPI Number Information
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    NPI Number           |    1497456313
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    Entity Type          |    Organization 
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    Legal Business Name  |    ABA AND BEHAVIORAL SUPPORTS, LLC 
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Dates
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    Enumeration Date     |    03/16/2023
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    Last Update Date     |    03/16/2023
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Provider Practice Location Address
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    Address Line         |    570 HEIMER RD 
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78232-5160
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    Country              |    US
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    Telephone            |    210-638-9048
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    570 HEIMER RD 
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78232-5160
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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    |    CFO
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    Name                 |     GLORI  NEWSOME 
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    Credential           |    
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    Telephone            |    210-638-9048
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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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