Organization
INGENIA BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX WITARSA (OWNER/ BCBA)
(617) 462-8178
Entity
Organization
Contact information
Practice address
11101 CRAZY WELL DR, AUSTIN, TX 78717-4679
(617) 462-8178
Mailing address
11101 CRAZY WELL DRIVE, AUSTIN, TX 78717
(617) 462-8178
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-09-5006
TX
Other
Enumeration date
04/06/2017
Last updated
04/06/2017
About Stedi
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