Provider Demographics
NPI:1902181191
Name:APPLIED EDUCATIONAL SERVICES, LLC
Entity Type:Organization
Organization Name:APPLIED EDUCATIONAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KINDRA
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:COLEMAN-BOULWARE
Authorized Official - Suffix:
Authorized Official - Credentials:MED, BCBA
Authorized Official - Phone:512-217-5913
Mailing Address - Street 1:23913 PEDERNALES CANYON TRL
Mailing Address - Street 2:
Mailing Address - City:SPICEWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:78669-6498
Mailing Address - Country:US
Mailing Address - Phone:512-264-9206
Mailing Address - Fax:
Practice Address - Street 1:23913 PEDERNALES CANYON TRL
Practice Address - Street 2:
Practice Address - City:SPICEWOOD
Practice Address - State:TX
Practice Address - Zip Code:78669-6498
Practice Address - Country:US
Practice Address - Phone:512-264-9206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-11-8453251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health