Provider Demographics
NPI:1295467355
Name:SANTANA, AXCEL (RBT)
Entity Type:Individual
Prefix:
First Name:AXCEL
Middle Name:
Last Name:SANTANA
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 E CONCHO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76903-5947
Mailing Address - Country:US
Mailing Address - Phone:325-777-2727
Mailing Address - Fax:325-777-2737
Practice Address - Street 1:136 E CONCHO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-5947
Practice Address - Country:US
Practice Address - Phone:325-777-2727
Practice Address - Fax:325-777-2737
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-22-221907106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician