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NPI Code Detail

MEDICARE: JONATHAN TIEH BCBA

MEDICARE: JONATHAN TIEH 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 Analyst

General Provider Information

NPI Number : 1669171476
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN TIEH BCBA
Provider Business Mailing Address
First Line : 6902 CHESSLEY CHASE DR
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-5954
Country : US
Telephone Number : 346-218-8861
Fax Number :
Provider Business Practice Location Address
First Line : 6914 BRISBANE CT
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-4923
Country : US
Telephone Number : 844-272-7223
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2023
Last Update Date : 03/01/2023

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