MEDICARE: MRS. AUTUMN MAKRIDIS BCBA

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
1	103K00000X	Behavior Analyst	1-21-48022	OH

General Provider Information

NPI Number	:	1982562377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AUTUMN MAKRIDIS BCBA

Provider Business Mailing Address
First Line	:	2920 HAMPSHIRE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43209-2651
Country	:	US
Telephone Number	:	740-704-5077
Fax Number	:

Provider Business Practice Location Address
First Line	:	2920 HAMPSHIRE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43209-2651
Country	:	US
Telephone Number	:	740-704-5077
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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