Provider Demographics
NPI:1073154316
Name:SKALA, DANIELLE BUCKNER (MED, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:BUCKNER
Last Name:SKALA
Suffix:
Gender:F
Credentials:MED, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 E PARK ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-4598
Mailing Address - Country:US
Mailing Address - Phone:512-588-1362
Mailing Address - Fax:
Practice Address - Street 1:2105 E PARK ST
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-4598
Practice Address - Country:US
Practice Address - Phone:125-588-1362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3030103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst