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NPI Code Detail

MEDICARE: JACKLYN BELLEW BCBA

MEDICARE: JACKLYN BELLEW 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 Analyst1-25-86601TX

General Provider Information

NPI Number : 1720943988
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACKLYN BELLEW BCBA
Provider Business Mailing Address
First Line : 919 MEDICAL DR STE 1200
Second Line :
City : ALLEN
State : TX
Zip : 75013-5756
Country : US
Telephone Number : 972-217-4110
Fax Number :
Provider Business Practice Location Address
First Line : 919 MEDICAL DR STE 1200
Second Line :
City : ALLEN
State : TX
Zip : 75013-5756
Country : US
Telephone Number : 972-217-4110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2025
Last Update Date : 12/19/2025

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Directions to “ JACKLYN BELLEW BCBA” Practice Location

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