Organization
LUMINA AUTISM CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SIMONA-DANIELA AKCIN BCBA, MBA (CLINICAL DIRECTOR/OWNER)
(404) 646-1168
Entity
Organization
Contact information
Practice address
1031 CAMBRIDGE SQ, SUITE F, ALPHARETTA, GA 30009-1869
(404) 647-1168
Mailing address
1031 CAMBRIDGE SQ, SUITE F, ALPHARETTA, GA 30009-1869
(404) 647-1168
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BCBA# 1-11-8451
GA
221700000X
Art Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225A00000X
Music Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12751126
CAQH
GA
Enumeration date
05/11/2016
Last updated
05/11/2016
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