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General NPI Number Information
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NPI Number | 1760748198
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Entity Type | Organization
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Legal Business Name | DEVELOPMENTAL INTERVENTIONS, LLC
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Dates
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Enumeration Date | 04/10/2012
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Last Update Date | 04/10/2012
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Provider Practice Location Address
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Address Line | 7639 SPANISH WOOD
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City | SAN ANTONIO
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State | TX
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Zip | 78249-4260
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Country | US
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Telephone | 210-884-8703
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Fax |
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Provider Business Mailing Address
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Address Line | 7639 SPANISH WOOD
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City | SAN ANTONIO
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State | TX
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Zip | 78249-4260
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Country | US
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Telephone | 210-884-8703
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Fax |
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Authorized Official
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Title or Position | OWNER/EXECUTIVE DIRECTOR
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Name | MR. JUSTIN AARON GARCIA BS, BCABA
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Credential |
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Telephone | 210-884-8703
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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 | 0-09-3536
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License Number State | TX
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