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NPI Code Detail

MEDICARE: AUTISM CONNECTION, INC.

MEDICARE: AUTISM CONNECTION, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1629909700
Entity Type Code : Organization
Provider Name (Legal Business Name) : AUTISM CONNECTION, INC.
Provider Business Mailing Address
First Line : 1709 COMMODORE ST
Second Line :
City : HAVRE DE GRACE
State : MD
Zip : 21078-1435
Country : US
Telephone Number : 727-366-0323
Fax Number :
Provider Business Practice Location Address
First Line : 33 KENSINGTON PKWY
Second Line :
City : ABINGDON
State : MD
Zip : 21009-1851
Country : US
Telephone Number : 727-366-0323
Fax Number :
Authorized Official
Title or Position : OWNER/DIRECTOR
Name : ANASTASIA KOUKOULIS
Credential : KOUKOULIS
Telephone Number : 727-366-0323
Provider Enumeration Date : 05/27/2026
Last Update Date : 05/27/2026

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Directions to “AUTISM CONNECTION, INC. ” Practice Location

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