Provider Demographics
NPI:1770055154
Name:VELASQUEZ, ANA K (BCBA)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:K
Last Name:VELASQUEZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:K
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:11623 ANGUS RD STE E20
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-4003
Mailing Address - Country:US
Mailing Address - Phone:512-827-7011
Mailing Address - Fax:
Practice Address - Street 1:11623 ANGUS RD STE E20
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4003
Practice Address - Country:US
Practice Address - Phone:512-827-7011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-22
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst