| Providence Behavior Therapy | |
|
701 Tillery St Ste 12 Austin TX 78702-3751 | |
| (512) 200-2792 | |
| (512) 295-0921 |
| Full Name | Providence Behavior Therapy |
|---|---|
| Speciality | Behavior Analyst |
| Location | 701 Tillery St Ste 12, Austin, Texas |
| Authorized Official Name and Position | Heather Skeen (OWNER) |
| Authorized Official Contact | 5122002792 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Behavior Therapy 701 Tillery St Ste 12 Austin TX 78702-3751 Ph: (512) 200-2792 | Providence Behavior Therapy 701 Tillery St Ste 12 Austin TX 78702-3751 Ph: (512) 200-2792 |
| NPI Number | 1003452574 |
|---|---|
| Provider Enumeration Date | 11/20/2019 |
| Last Update Date | 02/09/2021 |
| Certification Date | 02/09/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003452574 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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