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General NPI Number Information
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NPI Number | 1841657962
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Entity Type | Organization
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Legal Business Name | DUNKLIN HEALTH AND WELLNESS MANAGEMENT, LLC
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Dates
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Enumeration Date | 01/20/2016
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Last Update Date | 02/09/2016
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Provider Practice Location Address
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Address Line | 3201 CHERRY RIDGE ST SUITE 205
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City | SAN ANTONIO
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State | TX
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Zip | 78230-4823
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Country | US
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Telephone | 210-665-8875
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 90021
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City | SAN ANTONIO
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State | TX
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Zip | 78209-9021
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Country | US
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Telephone | 210-665-8875
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Fax |
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Authorized Official
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Title or Position | BEHAVIOR ANALYST
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Name | RAY C DUNKLIN JR.
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Credential | M.S., BCBA
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Telephone | 210-665-8875
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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 | 1-15-20931
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License Number State |
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