Provider Demographics
NPI:1255527487
Name:CORBIN-NEWSOME, JAWANDA J (MA,BCBA, LBA)
Entity type:Individual
Prefix:MRS
First Name:JAWANDA
Middle Name:J
Last Name:CORBIN-NEWSOME
Suffix:
Gender:F
Credentials:MA,BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 HEIMER RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-5160
Mailing Address - Country:US
Mailing Address - Phone:210-885-3481
Mailing Address - Fax:210-504-5084
Practice Address - Street 1:570 HEIMER RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-5160
Practice Address - Country:US
Practice Address - Phone:210-885-3481
Practice Address - Fax:210-504-5084
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1535103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst