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General NPI Number Information
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NPI Number | 1811615800
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Entity Type | Organization
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Legal Business Name | AVENUE BEHAVIOR CONSULTING
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Dates
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Enumeration Date | 08/16/2022
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 14317 POTRANCO RD STE 205, #327
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City | SAN ANTONIO
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State | TX
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Zip | 78253-7126
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Country | US
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Telephone | 210-323-8601
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Fax | 888-215-1365
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Provider Business Mailing Address
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Address Line | 14317 POTRANCO RD STE 205, #327
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City | SAN ANTONIO
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State | TX
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Zip | 78253-7126
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Country | US
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Telephone | 210-323-8601
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Fax | 888-215-1365
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Authorized Official
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Title or Position | CO-EO
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Name | CAROLANN MORRISON
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Credential | BCBA LBA
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Telephone | 210-323-8601
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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 |
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License Number State |
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