Provider Demographics
NPI:1760101927
Name:NYAKUNIKA, SIMUKAYI (LBA,BCBA)
Entity Type:Individual
Prefix:
First Name:SIMUKAYI
Middle Name:
Last Name:NYAKUNIKA
Suffix:
Gender:M
Credentials:LBA,BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 N WHITTINGTON PKWY FL 4
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-7101
Mailing Address - Country:US
Mailing Address - Phone:502-272-3434
Mailing Address - Fax:
Practice Address - Street 1:1600 NE LOOP 410 STE 114
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-1612
Practice Address - Country:US
Practice Address - Phone:210-370-3099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1695103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst