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NPI Code Detail

MEDICARE: GABRIEL GAFNER BCBA

MEDICARE: GABRIEL GAFNER BCBA
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 Analyst

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11-19-35166OTHERBCBA

General Provider Information

NPI Number : 1154882488
Entity Type Code : Individual
Provider Name (Legal Business Name) : GABRIEL GAFNER BCBA
Provider Business Mailing Address
First Line : PO BOX 151716
Second Line :
City : AUSTIN
State : TX
Zip : 78715-1716
Country : US
Telephone Number : 512-898-9044
Fax Number : 512-857-1423
Provider Business Practice Location Address
First Line : 4407 PACK SADDLE PASS
Second Line :
City : AUSTIN
State : TX
Zip : 78745-1623
Country : US
Telephone Number : 512-898-9044
Fax Number : 512-857-1423
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2019
Last Update Date : 06/11/2019

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