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General NPI Number Information
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NPI Number | 1770023962
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Entity Type | Organization
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Legal Business Name | A BALANCED CHILD , PLLC
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Dates
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Enumeration Date | 03/07/2017
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Last Update Date | 09/28/2023
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Provider Practice Location Address
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Address Line | 13003 JONES MALTSBERGER RD
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City | SAN ANTONIO
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State | TX
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Zip | 78247-4220
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Country | US
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Telephone | 210-979-2044
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Fax | 210-979-2049
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Provider Business Mailing Address
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Address Line | 15333 SAN PEDRO AVE
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City | HILL COUNTRY VILLAGE
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State | TX
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Zip | 78232-3719
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Country | US
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Telephone | 210-979-2044
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Fax | 210-979-2049
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MS. SERICA N CUELLAR
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Credential | BCBA
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Telephone | 210-979-2044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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