Provider Demographics
NPI:1689166233
Name:HUNNEWELL, AFTON MARIE (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:AFTON
Middle Name:MARIE
Last Name:HUNNEWELL
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 1:12900 E LOOP 1604 N APT 212
Mailing Address - Street 2:
Mailing Address - City:UNIVERSAL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78148-3171
Mailing Address - Country:US
Mailing Address - Phone:229-289-6104
Mailing Address - Fax:
Practice Address - Street 1:201 E LLANO ESTACADO BLVD
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-3708
Practice Address - Country:US
Practice Address - Phone:575-763-9517
Practice Address - Fax:575-742-2369
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-17-43196106S00000X
1-21-49528103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician