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General NPI Number Information
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NPI Number | 1679871628
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Entity Type | Individual
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Provider Name | KURT MARSHALL MESKOWSKY BCBA
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Gender | Male
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Dates
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Enumeration Date | 02/28/2011
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Last Update Date | 02/28/2011
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Provider Practice Location Address
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Address Line | 1465 REGENT CIR
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City | LINCOLN
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State | CA
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Zip | 95648-3222
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Country | US
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Telephone | 916-316-7333
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Fax | 916-543-7909
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Provider Business Mailing Address
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Address Line | 1465 REGENT CIR
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City | LINCOLN
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State | CA
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Zip | 95648-3222
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Country | US
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Telephone | 916-316-7333
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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 | 01-06-3197
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License Number State | FL
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