Provider Demographics
NPI:1003092255
Name:NULK, CHRISTINA MARIE (MS, BCBA)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:NULK
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13695
Mailing Address - Street 2:
Mailing Address - City:FT CARSON
Mailing Address - State:CO
Mailing Address - Zip Code:80902-0695
Mailing Address - Country:US
Mailing Address - Phone:719-271-9975
Mailing Address - Fax:719-404-4126
Practice Address - Street 1:6050 ERIN PARK DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-3488
Practice Address - Country:US
Practice Address - Phone:719-465-3989
Practice Address - Fax:719-375-8499
Is Sole Proprietor?:No
Enumeration Date:2008-01-18
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0384258174400000X
3747P1801X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No174400000XOther Service ProvidersSpecialist
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant