Individual
IVELIS SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
300 LABOR ST APT 1213, SAN ANTONIO, TX 78210-1095
(409) 302-5624
Mailing address
300 LABOR ST APT 1213, SAN ANTONIO, TX 78210-1095
(210) 322-6223
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
6431
TX
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
09/20/2023
Last updated
03/05/2026
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