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General NPI Number Information
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NPI Number | 1528957404
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Entity Type | Individual
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Provider Name | JENNIFER BRANDT
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Gender | Female
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 24200 W INTERSTATE 10 STE 109
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City | SAN ANTONIO
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State | TX
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Zip | 78257-1150
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Country | US
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Telephone | 210-858-6933
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Fax |
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Provider Business Mailing Address
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Address Line | 27595 INTERSTATE 10 W APT 928
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City | BOERNE
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State | TX
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Zip | 78006-6679
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Country | US
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Telephone | 210-723-5767
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-25-417950
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License Number State | TX
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