Provider Demographics
NPI:1336479336
Name:KULIKOWSKI, LAURA LEE (BCBA)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:LEE
Last Name:KULIKOWSKI
Suffix:
Gender:F
Credentials: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 35
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34681-0035
Mailing Address - Country:US
Mailing Address - Phone:813-260-4913
Mailing Address - Fax:813-756-1093
Practice Address - Street 1:318 ONTARIO AVENUE
Practice Address - Street 2:
Practice Address - City:CRYSTAL BEACH
Practice Address - State:FL
Practice Address - Zip Code:34681
Practice Address - Country:US
Practice Address - Phone:813-260-4913
Practice Address - Fax:813-756-1093
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-13
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist