Provider Demographics
NPI:1356595904
Name:AUTISM SPECTRUM INSTRUCTIONAL RESOURCES, LLC
Entity type:Organization
Organization Name:AUTISM SPECTRUM INSTRUCTIONAL RESOURCES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GOURIS
Authorized Official - Suffix:
Authorized Official - Credentials:MED, BCBA
Authorized Official - Phone:512-656-1835
Mailing Address - Street 1:13405 SADDLE BACK PASS
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78738-6149
Mailing Address - Country:US
Mailing Address - Phone:512-656-1835
Mailing Address - Fax:512-263-5866
Practice Address - Street 1:13405 SADDLE BACK PASS
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78738-6149
Practice Address - Country:US
Practice Address - Phone:512-656-1835
Practice Address - Fax:512-263-5866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-05-2554251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health