Basic Information
| Provider Information | |||||||||
| NPI: | 1619383643 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOTELLO GARCIA | ||||||||
| FirstName: | ALMA | ||||||||
| MiddleName: | XOCHITL | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.ED., BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12708 LEE PARK LN | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787322365 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9795998295 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3006 BEE CAVES RD | ||||||||
| Address2: | SUITE B-200 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787465588 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123285599 | ||||||||
| FaxNumber: | 5123285585 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2014 | ||||||||
| LastUpdateDate: | 07/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 1-14-16044 | TX | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.