Organization
AUTISM CONSULTING NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRYSTIN BULLOCK MS BCBA (EXECUTIVE DIRECTOR)
(850) 583-1911
Entity
Organization
Contact information
Practice address
203 EAST 10TH STREET, SANFORD, FL 32771
(850) 583-1911
Mailing address
203 EAST 10TH STREET, SANFORD, FL 32771
(850) 583-1911
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
BCBA 1-05-2521
—
251S00000X
Community/Behavioral Health Agency
BCBA 1-05-2521
—
Other
Enumeration date
12/14/2009
Last updated
12/14/2009
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