Provider Demographics
NPI:1689138042
Name:BYKOWSKI, ANDREW DAVID (BCBA, MS)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:DAVID
Last Name:BYKOWSKI
Suffix:
Gender:M
Credentials:BCBA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 MAPLEWYNDE RD
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-4939
Mailing Address - Country:US
Mailing Address - Phone:262-510-7747
Mailing Address - Fax:
Practice Address - Street 1:2665 S MOORLAND RD STE 100
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-2900
Practice Address - Country:US
Practice Address - Phone:414-475-1896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI279-140103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst