Individual
MIRIAM BURLAKOVSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.S, BCBA, LEP#4368
Contact information
Practice address
901 OAK PARK BLVD STE 202, PISMO BEACH, CA 93449-3410
(805) 316-1410
Mailing address
PO BOX 565, PISMO BEACH, CA 93448-0565
(805) 316-1410
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-12-10527
CA
103TS0200X
School Psychologist
Primary
4368
CA
Other
Enumeration date
01/11/2025
Last updated
10/12/2025
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