Pediatric Action Therapy, LLC
Organization Active NPI Behavior Analyst · Boerne, TX
NPI 1477875656 · NPPES record last updated Jan 18, 2017
Key facts
- NPI
- 1477875656
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 1096577
- Legal business name
- PEDIATRIC ACTION THERAPY, LLC
- Practice address
- 12 Der Flugplatz
Boerne, TX 78006-8661 - Phone
- (954) 540-1360
- Fax
- (830) 755-6525
- NPI assigned
- Feb 16, 2010
- Organization subpart
- No
Authorized official
- Name
- Ms. Diana Marcela Barrera, MOT, OTR, BCBA, C/ND
- Title
- Executive Director
- Phone
- (954) 540-1360
Practitioners 7
-
Diana Marcela Barrera, MOT OTR, BCBA
-
Sandra B Barrera, RBT
-
Conan James Bicknell, RBT
-
Joe Everett Vandzura, RBT
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst |
103K00000X | 1096577 | Yes | |
| Pediatric Occupational Therapist |
225XP0200X | 111734 | TX | |
| Speech-Language Pathologist |
235Z00000X |
Addresses
Primary practice location
12 Der Flugplatz
Boerne, TX 78006-8661
Mailing address
12 Der Flugplatz
Boerne, TX 78006-8661
Phone (954) 540-1360
Other providers in Boerne, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.