Provider Demographics
NPI:1063972909
Name:BETCHAN, HEATHER ALAYNE (MA, BCBA, LBA-TX)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ALAYNE
Last Name:BETCHAN
Suffix:
Gender:F
Credentials:MA, BCBA, LBA-TX
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 DEEP WOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-4934
Mailing Address - Country:US
Mailing Address - Phone:512-760-6830
Mailing Address - Fax:
Practice Address - Street 1:171 DEEP WOOD DR
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4934
Practice Address - Country:US
Practice Address - Phone:512-910-3251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-25
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-19-35377103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty