Provider Demographics
NPI:1710238829
Name:JURIK, CHRISTINE (MA, BCBA, COBA)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:JURIK
Suffix:
Gender:F
Credentials:MA, BCBA, COBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2008 SAVANNAH PKWY
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-1852
Mailing Address - Country:US
Mailing Address - Phone:440-420-1170
Mailing Address - Fax:
Practice Address - Street 1:2008 SAVANNAH PKWY
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-1852
Practice Address - Country:US
Practice Address - Phone:440-420-6507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-28
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst