Kassandra Gonzalez
Behavior Technician in San Antonio, TX. Individual provider (NPI-1).
NPI number1164055984
StatusActive
Last updated in NPPESFeb 20, 2020
Details
- NPI
- 1164055984
- Entity type
- Individual (NPI-1)
- Name
- Kassandra Gonzalez
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 20, 2020
- Certification date
- Feb 20, 2020
- Last updated
- Feb 20, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | BACB557862 | TX | Yes |
Practice location
11103 West Ave Ste 108San Antonio, TX 78213-4915
Phone 210-340-2627
Mailing address
11103 West Ave Ste 108San Antonio, TX 78213-4915
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