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Organization
APPLIED SUPPORT FOR AUTISM LLC
Active
Organization
APPLIED SUPPORT FOR AUTISM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARILYN LIZARDO M.S. SP. ED. (ABA PROVIDER)
(718) 313-6979
Entity
Organization
Contact information
Practice address
915 BUSHWICK AVE, BROOKLYN, NY 11221-3738
(718) 313-6979
Mailing address
915 BUSHWICK AVE, BROOKLYN, NY 11221-3738
(718) 313-6979
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
800913131
NY
Other
Enumeration date
11/22/2016
Last updated
11/22/2016
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