Individual
BRENDA LI GAVILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
5307 W HIGHWAY 290 BLDG B-11, AUSTIN, TX 78735-8965
(512) 423-4467
Mailing address
6104 OLD FREDERICKSBURG RD # 90851, AUSTIN, TX 78749-1216
(512) 423-4467
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
5952
TX
106E00000X
Assistant Behavior Analyst
12808
TX
106S00000X
Behavior Technician
RBT-20-118471
TX
Other
Enumeration date
04/01/2021
Last updated
06/16/2023
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