Provider Demographics
NPI:1831565795
Name:NURTURE AND NATURE ABA AND CONSULTATION
Entity type:Organization
Organization Name:NURTURE AND NATURE ABA AND CONSULTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-423-2215
Mailing Address - Street 1:5318 LAUREL CANYON BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-2752
Mailing Address - Country:US
Mailing Address - Phone:818-423-2215
Mailing Address - Fax:818-423-2214
Practice Address - Street 1:5318 LAUREL CANYON BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-2752
Practice Address - Country:US
Practice Address - Phone:818-423-2215
Practice Address - Fax:818-423-2214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health