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NPI Code Detail

MEDICARE: BRENT WOODALL FOUNDATION FOR EXCEPTIONAL CHILDREN

MEDICARE: BRENT WOODALL FOUNDATION FOR EXCEPTIONAL CHILDREN
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
2106E00000XAssistant Behavior Analyst
3106S00000XBehavior Technician
4261Q00000XClinic/Center
5251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1386879526
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRENT WOODALL FOUNDATION FOR EXCEPTIONAL CHILDREN
Provider Business Mailing Address
First Line : 7801 MESQUITE BEND DR STE 105
Second Line :
City : IRVING
State : TX
Zip : 75063-6043
Country : US
Telephone Number : 972-756-9170
Fax Number : 214-614-4650
Provider Business Practice Location Address
First Line : 7801 MESQUITE BEND DR STE 105
Second Line :
City : IRVING
State : TX
Zip : 75063-6043
Country : US
Telephone Number : 972-756-9170
Fax Number : 214-614-4650
Authorized Official
Title or Position : DIRECTOR
Name : MRS. CARLEY MICHELE WALTENBURG
Credential : M.S.
Telephone Number : 972-756-9170
Provider Enumeration Date : 05/18/2009
Last Update Date : 04/03/2024

Similar Medicare Providers

1881548345 — BRITNEY LOYD
Practice Location Address:
7801 MESQUITE BEND DR STE 105
IRVING, TX
75063-6043
Practice Phone: 972-756-9170
Practice Fax:
1831413533 — TRACY PIERCE WOODALL PHD-ABD, BCBA
Practice Location Address:
7801 MESQUITE BEND DR STE 105
IRVING, TX
75063-6043
Practice Phone: 972-756-9170
Practice Fax:
1023493970 — CARLEY WALTENBURG M.S., BCBA
Practice Location Address:
7801 MESQUITE BEND DR STE 105
IRVING, TX
75063-6043
Practice Phone: 972-672-6717
Practice Fax:
1750758041 — IRINA PASAT M.S., BCBA
Practice Location Address:
7801 MESQUITE BEND DR STE 105
IRVING, TX
75063-6043
Practice Phone: 972-756-9170
Practice Fax: 214-614-4650
1619349842 — JENNIFER CHEN MS, BCBA
Practice Location Address:
7801 MESQUITE BEND DR STE 105
IRVING, TX
75063-6043
Practice Phone: 972-756-9170
Practice Fax: 214-614-4650
1912449828 — AMERICA FIRST PHARMACIES INC
Practice Location Address:
7801 MESQUITE BEND DR , SUITE 108
IRVING, TX
75063-6043
Practice Phone: 972-947-2400
Practice Fax: 972-947-2424

Directions to “BRENT WOODALL FOUNDATION FOR EXCEPTIONAL CHILDREN ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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