Provider Demographics
NPI:1740674746
Name:RESTO, CRISTINA (MA, BCBA)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:RESTO
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5030 78TH AVE N STE 11
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-2406
Mailing Address - Country:US
Mailing Address - Phone:407-747-7055
Mailing Address - Fax:
Practice Address - Street 1:5030 78TH AVE N STE 11
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-2406
Practice Address - Country:US
Practice Address - Phone:727-545-1273
Practice Address - Fax:800-713-8330
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-27
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-24-74490103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty