MEDICARE: GATEWAY LEARNING LLC

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	:	1265150791
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GATEWAY LEARNING LLC

Provider Business Mailing Address
First Line	:	1203 E LIVE OAK ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-5239
Country	:	US
Telephone Number	:	512-866-2166
Fax Number	:

Provider Business Practice Location Address
First Line	:	1203 E LIVE OAK ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-5239
Country	:	US
Telephone Number	:	512-866-2166
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RUTH LEORA BEKKER
Credential	:	BCBA
Telephone Number	:	512-415-0294

Provider Enumeration Date	:	08/19/2022
Last Update Date	:	11/17/2022

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Directions to “GATEWAY LEARNING LLC ” Practice Location

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