Provider Demographics
NPI:1225320732
Name:LOMBARDO, KRISTI WITKOWSKI (MSED, BCBA)
Entity Type:Individual
Prefix:MS
First Name:KRISTI
Middle Name:WITKOWSKI
Last Name:LOMBARDO
Suffix:
Gender:F
Credentials:MSED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 BURLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-1406
Mailing Address - Country:US
Mailing Address - Phone:781-761-5165
Mailing Address - Fax:781-275-7207
Practice Address - Street 1:205 BURLINGTON RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-1406
Practice Address - Country:US
Practice Address - Phone:781-761-5165
Practice Address - Fax:781-275-7207
Is Sole Proprietor?:No
Enumeration Date:2011-05-03
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1041861103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1004745OtherFALLON
MA1303287OtherMBHP
MAM18633OtherBCBS
MA99618201OtherNETWORK HEALTH
MA0000023532OtherBMC
MA042611055OtherTAX ID
MA1004745OtherNHP