=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588094536
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HEATHER SKEEN BCBA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/12/2013
-----------------------------------------------------
Last Update Date | 05/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 119 CIMARRON PARK LOOP STE A
-----------------------------------------------------
City | BUDA
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78610-2839
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-200-2792
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 701 TILLERY ST STE 12
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78702-3751
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number | 2723
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------