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General NPI Number Information
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NPI Number | 1811325871
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Entity Type | Individual
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Provider Name | ROMINA KAMBAJI ILUNGA BCBA
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Gender | Female
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Dates
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Enumeration Date | 10/29/2013
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Last Update Date | 12/21/2018
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Provider Practice Location Address
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Address Line | 390 UNION BLVD STE 300
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City | LAKEWOOD
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State | CO
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Zip | 80228-6514
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Country | US
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Telephone | 707-672-6610
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Fax |
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Provider Business Mailing Address
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Address Line | 350 S JACKSON ST APT 407
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City | DENVER
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State | CO
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Zip | 80209-3359
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Country | US
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Telephone | 818-536-8943
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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 | 1-13-13956
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License Number State | CA
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