Provider Demographics
NPI:1285300236
Name:BEHAVIORAL HEALTH FUNDAMENTALS PLLC
Entity type:Organization
Organization Name:BEHAVIORAL HEALTH FUNDAMENTALS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ BCBA / DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:J
Authorized Official - Last Name:DUKE
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, PHD
Authorized Official - Phone:210-844-9469
Mailing Address - Street 1:255 MEADOW GLADE DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78227-1005
Mailing Address - Country:US
Mailing Address - Phone:210-528-0699
Mailing Address - Fax:
Practice Address - Street 1:255 MEADOW GLADE DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78227-1005
Practice Address - Country:US
Practice Address - Phone:210-528-0699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-19
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty