Individual
JARRED DEPTAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., BCBA, LBA
Contact information
Practice address
121 INTERPARK BLVD STE 104, SAN ANTONIO, TX 78216-1844
(726) 201-1287
Mailing address
121 INTERPARK BLVD STE 104, SAN ANTONIO, TX 78216-1844
(726) 201-1287
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-69336
TX
Other
Enumeration date
10/13/2022
Last updated
11/06/2025
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