Individual
KYRA ANNE WIDEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20702 STONE OAK PKWY, SAN ANTONIO, TX 78258-7478
(512) 254-0016
Mailing address
20702 STONE OAK PKWY, SAN ANTONIO, TX 78258-7478
(706) 536-9866
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
4176
TX
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
09/16/2019
Last updated
03/17/2026
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