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NPI Code Detail

MEDICARE: ELIZABETH MARIE CERVANTES RBT

MEDICARE: ELIZABETH MARIE CERVANTES RBT
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 Technician

General Provider Information

NPI Number : 1598263923
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH MARIE CERVANTES RBT
Provider Business Mailing Address
First Line : 140 HEIMER RD STE 710
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78232-5070
Country : US
Telephone Number : 210-366-0049
Fax Number :
Provider Business Practice Location Address
First Line : 2525 LADD ST
Second Line :
City : LACKLAND AFB
State : TX
Zip : 78236-5308
Country : US
Telephone Number : 210-538-5292
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2018
Last Update Date : 02/13/2023

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Directions to “ ELIZABETH MARIE CERVANTES RBT” Practice Location

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