Provider Demographics
NPI:1366017766
Name:CELLA, ANNABELLE (MED, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:ANNABELLE
Middle Name:
Last Name:CELLA
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 1:101 COLORADO ST APT 704
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-4110
Mailing Address - Country:US
Mailing Address - Phone:314-277-0995
Mailing Address - Fax:
Practice Address - Street 1:1516 E PALM VALLEY BLVD BLDG C
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-4619
Practice Address - Country:US
Practice Address - Phone:512-733-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4127103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst