Provider Demographics
NPI:1164960258
Name:LINDBERG, CHRISTINA (MAT, BCBA)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:LINDBERG
Suffix:
Gender:F
Credentials:MAT, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 GEM LN
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11762-3222
Mailing Address - Country:US
Mailing Address - Phone:516-250-3131
Mailing Address - Fax:
Practice Address - Street 1:77 GEM LN
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA PARK
Practice Address - State:NY
Practice Address - Zip Code:11762-3222
Practice Address - Country:US
Practice Address - Phone:516-250-3131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-08
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst