=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972472314
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DONNA LYNN WOODWORTH RBT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/03/2025
-----------------------------------------------------
Last Update Date | 11/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1001 PAT BOOKER RD STE 206
-----------------------------------------------------
City | UNIVERSAL CITY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78148-4148
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-439-1386
-----------------------------------------------------
Fax | 210-352-9572
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 706 TORREY PNES
-----------------------------------------------------
City | CIBOLO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78108-4377
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-514-3512
-----------------------------------------------------
Fax | 832-452-2311
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------