MEDICARE: DEVELOPMENT FOR AUTISM AND RELATED TREATMENT

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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1154024024
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEVELOPMENT FOR AUTISM AND RELATED TREATMENT

Provider Business Mailing Address
First Line	:	1920 E RIVERSIDE DR STE A-120
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78741-1350
Country	:	US
Telephone Number	:	714-932-8704
Fax Number	:

Provider Business Practice Location Address
First Line	:	1116 ELEANOR ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78721-2116
Country	:	US
Telephone Number	:	714-932-8704
Fax Number	:

Authorized Official
Title or Position	:	BCBA
Name	:	MRS. MEGAN ELIZABETH MOUNT
Credential	:	MA, BCBA
Telephone Number	:	714-932-8704

Provider Enumeration Date	:	03/22/2023
Last Update Date	:	04/26/2023

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Directions to “DEVELOPMENT FOR AUTISM AND RELATED TREATMENT ” Practice Location

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