Provider Demographics
NPI:1679085914
Name:VELA, ISABEL (BCBA)
Entity Type:Individual
Prefix:
First Name:ISABEL
Middle Name:
Last Name:VELA
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 MOCKINGBIRD HILL DR.
Mailing Address - Street 2:
Mailing Address - City:JOSHUA
Mailing Address - State:TX
Mailing Address - Zip Code:76058-5947
Mailing Address - Country:US
Mailing Address - Phone:520-456-7071
Mailing Address - Fax:
Practice Address - Street 1:140 MOCKINGBIRD HILL DR
Practice Address - Street 2:
Practice Address - City:JOSHUA
Practice Address - State:TX
Practice Address - Zip Code:76058
Practice Address - Country:US
Practice Address - Phone:520-456-7071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-26
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-18-30606103K00000X
TX16-19495106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1-18-30606OtherBCBA CERTIFICATION