Provider Demographics
NPI:1770023962
Name:A BALANCED CHILD , PLLC
Entity Type:Organization
Organization Name:A BALANCED CHILD , PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SERICA
Authorized Official - Middle Name:N
Authorized Official - Last Name:CUELLAR
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:210-979-2044
Mailing Address - Street 1:15333 SAN PEDRO AVE
Mailing Address - Street 2:
Mailing Address - City:HILL COUNTRY VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:78232-3719
Mailing Address - Country:US
Mailing Address - Phone:210-979-2044
Mailing Address - Fax:210-979-2049
Practice Address - Street 1:13003 JONES MALTSBERGER RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-4220
Practice Address - Country:US
Practice Address - Phone:210-979-2044
Practice Address - Fax:210-979-2049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-07
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty