1528313418 NPI number — RENEE GUENTHER ABSHER M.ED, BCBA

Table of content: RENEE GUENTHER ABSHER M.ED, BCBA (NPI 1528313418)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528313418 NPI number — RENEE GUENTHER ABSHER M.ED, BCBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ABSHER
Provider First Name:
RENEE
Provider Middle Name:
GUENTHER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.ED, BCBA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ABSHER
Provider Other First Name:
RENEE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
BCBA-BEHAVIORAL HEAL
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1528313418
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6502 NURSERY DR.
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
VICTORIA
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77904
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
361-575-0611
Provider Business Mailing Address Fax Number:
361-579-6913

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6502 NURSERY DR.
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
VICTORIA
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77904
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-575-0611
Provider Business Practice Location Address Fax Number:
361-579-6913
Provider Enumeration Date:
07/17/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X , with the licence number:  1-12-11641 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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