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General NPI Number Information
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NPI Number | 1598481129
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Entity Type | Individual
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Provider Name | SARAH GRACE MATA BCABA
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Gender | Female
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Dates
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Enumeration Date | 10/14/2022
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 605 FREEMONT
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City | SPRING BRANCH
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State | TX
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Zip | 78070-3701
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Country | US
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Telephone | 903-746-9221
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Fax |
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Provider Business Mailing Address
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Address Line | 700 N SAINT MARYS ST STE 1400
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City | SAN ANTONIO
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State | TX
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Zip | 78205-3535
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Country | US
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Telephone | 210-866-3780
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 9124
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License Number State | TX
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