Healthcare Provider Details

I. General information

NPI: 1922463736
Provider Name (Legal Business Name): UBUNTU AUTISM CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2015
Last Update Date: 02/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 CEDAR HILL ST STE 200
MARLBOROUGH MA
01752-5900
US

IV. Provider business mailing address

225 CEDAR HILL ST STE 200
MARLBOROUGH MA
01752-5900
US

V. Phone/Fax

Practice location:
  • Phone: 508-202-0506
  • Fax: 508-519-5351
Mailing address:
  • Phone: 508-202-0506
  • Fax: 508-519-5351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-14-9986
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateMA

VIII. Authorized Official

Name: GRACE GITAU
Title or Position: CO-FOUNDER
Credential: BBA
Phone: 774-312-1810