=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558285817
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENA L CALLAHAN RBT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/07/2026
-----------------------------------------------------
Last Update Date | 08/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12606 GREENVILLE AVE STE 260
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75243-1921
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 844-224-2388
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3510 RIDGEMOOR DR
-----------------------------------------------------
City | GARLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75044-6526
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 346-355-3463
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number | RBT-25-426352
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------