Individual
AVERY LEANN HERNDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21727 W INTERSTATE 10 STE 108, SAN ANTONIO, TX 78257-2108
(210) 455-1091
Mailing address
125 RATTLESNAKE BLF, BOERNE, TX 78006-1961
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
23-262431
TX
Other
Enumeration date
03/16/2023
Last updated
03/16/2023
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