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NPI Code Detail

MEDICARE: ERIN KIMBERLY NEELY BCBA

MEDICARE: ERIN KIMBERLY NEELY 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
1106S00000XBehavior TechnicianRBT-16-18007
2103K00000XBehavior Analyst5228TX

General Provider Information

NPI Number : 1174266613
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN KIMBERLY NEELY BCBA
Provider Business Mailing Address
First Line : 21718 CLIFF VW
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78259-2042
Country : US
Telephone Number : 210-385-3472
Fax Number :
Provider Business Practice Location Address
First Line : 121 INTERPARK BLVD STE 104
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78216-1844
Country : US
Telephone Number : 888-754-0398
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2022
Last Update Date : 02/22/2024

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Directions to “ ERIN KIMBERLY NEELY BCBA” Practice Location

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