Provider Demographics
NPI:1407277908
Name:SPECIALIZED AUTISM CONSULTANTS
Entity Type:Organization
Organization Name:SPECIALIZED AUTISM CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:
Authorized Official - Last Name:MWAURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-587-1050
Mailing Address - Street 1:599 NORTH AVENUE
Mailing Address - Street 2:8
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:599 NORTH AVENUE
Practice Address - Street 2:STE. 8
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880
Practice Address - Country:US
Practice Address - Phone:781-587-1050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-30
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health