Provider Demographics
NPI:1689276057
Name:GRANADOS, DANIELA (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:GRANADOS
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28286 BOERNE STAGE RD #3
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006
Mailing Address - Country:US
Mailing Address - Phone:830-816-5510
Mailing Address - Fax:855-421-1717
Practice Address - Street 1:28286 BOERNE STAGE RD #3
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006
Practice Address - Country:US
Practice Address - Phone:830-816-5510
Practice Address - Fax:855-421-1717
Is Sole Proprietor?:No
Enumeration Date:2020-11-11
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-24-76439106S00000X
106S00000X
TX7622103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician