| Ingenia Behavioral Health Llc | |
|
11101 Crazy Well Dr Austin TX 78717-4679 | |
| (617) 462-8178 | |
| Not Available |
| Full Name | Ingenia Behavioral Health Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 11101 Crazy Well Dr, Austin, Texas |
| Authorized Official Name and Position | Alex Witarsa (OWNER/ BCBA) |
| Authorized Official Contact | 6174628178 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ingenia Behavioral Health Llc 11101 Crazy Well Drive Austin TX 78717 Ph: (617) 462-8178 | Ingenia Behavioral Health Llc 11101 Crazy Well Dr Austin TX 78717-4679 Ph: (617) 462-8178 |
| NPI Number | 1730612813 |
|---|---|
| Provider Enumeration Date | 04/06/2017 |
| Last Update Date | 04/06/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730612813 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-09-5006 (Texas) | Primary |
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