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General NPI Number Information
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NPI Number | 1861074981
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Entity Type | Organization
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Legal Business Name | VIBRANT ABA SOLUTIONS LLC
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Dates
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Enumeration Date | 04/27/2021
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Last Update Date | 04/27/2021
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Provider Practice Location Address
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Address Line | 7507 VIRTUOSO PASS
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City | SAN ANTONIO
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State | TX
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Zip | 78266-2944
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Country | US
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Telephone | 210-702-1611
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Fax |
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Provider Business Mailing Address
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Address Line | 11844 BANDERA RD # 201
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City | HELOTES
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State | TX
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Zip | 78023-4132
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Country | US
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Telephone | 210-319-9807
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MAITE HARRIS
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Credential | BCBA
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Telephone | 210-319-9807
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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