Provider Demographics
NPI:1447667530
Name:ADVANCED BEHAVIORAL INTERVENTIONS
Entity type:Organization
Organization Name:ADVANCED BEHAVIORAL INTERVENTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIORAL ANALYST AND CONSULTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEFANI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BACHMEIER CLEMMER
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:210-264-7053
Mailing Address - Street 1:7113 SAN PEDRO AVE # 184
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6219
Mailing Address - Country:US
Mailing Address - Phone:210-264-7053
Mailing Address - Fax:210-257-8399
Practice Address - Street 1:7113 SAN PEDRO AVE # 184
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6219
Practice Address - Country:US
Practice Address - Phone:210-264-7053
Practice Address - Fax:210-257-8399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-11-9044103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty