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NPI Code Detail

MEDICARE: MCKINSIE OBLAD BCBA

MEDICARE: MCKINSIE OBLAD 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 Analyst11728923UT

General Provider Information

NPI Number : 1366830135
Entity Type Code : Individual
Provider Name (Legal Business Name) : MCKINSIE OBLAD BCBA
Provider Business Mailing Address
First Line : 11138 HUEBNER OAKS APT 387
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78230-1278
Country : US
Telephone Number : 801-673-2839
Fax Number :
Provider Business Practice Location Address
First Line : 700 N SAINT MARYS ST STE 1400
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78205-3535
Country : US
Telephone Number : 801-673-2839
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2015
Last Update Date : 10/19/2020

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Directions to “ MCKINSIE OBLAD BCBA” Practice Location

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