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General NPI Number Information
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NPI Number | 1881250553
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Entity Type | Organization
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Legal Business Name | TABULA RASA ABA THERAPY, PLLC
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Dates
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Enumeration Date | 05/17/2019
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 8700 CROWNHILL BLVD STE 302
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City | SAN ANTONIO
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State | TX
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Zip | 78209-1128
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Country | US
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Telephone | 210-500-0077
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Fax |
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Provider Business Mailing Address
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Address Line | 7108 QUIMPER LN
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City | AUSTIN
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State | TX
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Zip | 78749-1949
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER ALANIZ
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Credential |
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Telephone | 210-837-6488
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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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