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NPI Code Detail

MEDICARE: AMANDA JAHN M.A., BCBA, LBA

MEDICARE: AMANDA JAHN M.A., BCBA, LBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-13-13044TX

General Provider Information

NPI Number : 1063855773
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA JAHN M.A., BCBA, LBA
Provider Business Mailing Address
First Line : 6222 W IH 10 STE 104
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78201-2013
Country : US
Telephone Number : 210-447-0039
Fax Number :
Provider Business Practice Location Address
First Line : 6222 W IH 10 STE 104
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78201-2013
Country : US
Telephone Number : 210-447-0039
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2013
Last Update Date : 03/31/2022

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