Provider Demographics
NPI:1467829747
Name:AUTISM BEHAVIORAL AND EDUCATIONAL CONSULTING
Entity type:Organization
Organization Name:AUTISM BEHAVIORAL AND EDUCATIONAL CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:TILLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MED, BCBA
Authorized Official - Phone:720-226-5078
Mailing Address - Street 1:2890 S NEWCOMBE WAY
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-2626
Mailing Address - Country:US
Mailing Address - Phone:720-226-5078
Mailing Address - Fax:
Practice Address - Street 1:2890 S NEWCOMBE WAY
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-2626
Practice Address - Country:US
Practice Address - Phone:720-226-5078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-21
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health