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General NPI Number Information
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NPI Number | 1760101927
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Entity Type | Individual
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Provider Name | SIMUKAYI NYAKUNIKA LBA,BCBA
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Gender | Male
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Dates
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Enumeration Date | 08/23/2022
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Last Update Date | 08/23/2022
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Provider Practice Location Address
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Address Line | 1600 NE LOOP 410 STE 114
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City | SAN ANTONIO
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State | TX
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Zip | 78209-1612
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Country | US
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Telephone | 210-370-3099
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Fax |
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Provider Business Mailing Address
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Address Line | 805 N WHITTINGTON PKWY FL 4
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City | LOUISVILLE
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State | KY
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Zip | 40222-7101
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Country | US
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Telephone | 502-272-3434
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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 | 1695
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License Number State | TX
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