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General NPI Number Information
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NPI Number | 1154955110
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Entity Type | Individual
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Provider Name | KAITLIN ZIOMKOWSKI BCBA, LBA, COBA
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Gender | Female
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Dates
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Enumeration Date | 02/28/2020
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 6196 LAKE GRAY BLVD STE 116
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City | JACKSONVILLE
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State | FL
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Zip | 32244-5867
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Country | US
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Telephone | 800-356-4049
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Fax |
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Provider Business Mailing Address
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Address Line | 6309 CROSSHALL PL
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City | WAXHAW
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State | NC
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Zip | 28173-7115
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Country | US
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Telephone | 513-295-1850
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 12156967
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License Number State |
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