Provider Demographics
NPI:1366722548
Name:ADVANCED BEHAVIORAL INTERVENTIONS LLC
Entity type:Organization
Organization Name:ADVANCED BEHAVIORAL INTERVENTIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BEHAVIORAL SPECIALIST/ 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:MA, BCBA
Authorized Official - Phone:210-264-7053
Mailing Address - Street 1:11735 SHOTGUN WAY
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-4445
Mailing Address - Country:US
Mailing Address - Phone:210-264-7053
Mailing Address - Fax:
Practice Address - Street 1:11735 SHOTGUN WAY
Practice Address - Street 2:
Practice Address - City:HELOTES
Practice Address - State:TX
Practice Address - Zip Code:78023-4445
Practice Address - Country:US
Practice Address - Phone:210-264-7053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-11-9044252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency