Provider Demographics
NPI:1447560131
Name:AUTISM & BEHAVIORAL CONSULTING, LLC
Entity Type:Organization
Organization Name:AUTISM & BEHAVIORAL CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CONSULTANT
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KOSMERL
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, BCBA-D
Authorized Official - Phone:615-247-0511
Mailing Address - Street 1:2290 10TH AVE N STE 105
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-6609
Mailing Address - Country:US
Mailing Address - Phone:615-247-0511
Mailing Address - Fax:877-283-4022
Practice Address - Street 1:2290 10TH AVE N STE 105
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-6609
Practice Address - Country:US
Practice Address - Phone:615-247-0511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty