Provider Demographics
NPI:1174056949
Name:ASEL, AMANDA BROOKE (BCBA)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:BROOKE
Last Name:ASEL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:BROOKE
Other - Last Name:BELMARES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:711 N PALMETTO
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78202-2353
Mailing Address - Country:US
Mailing Address - Phone:210-284-3467
Mailing Address - Fax:
Practice Address - Street 1:711 N PALMETTO
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78202-2353
Practice Address - Country:US
Practice Address - Phone:210-284-3467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-07
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-17-25199103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst