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General NPI Number Information
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NPI Number | 1841785441
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Entity Type | Organization
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Legal Business Name | CORNERSTONE SPECIAL EDUCATION ALLIANCE
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Dates
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Enumeration Date | 06/26/2018
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Last Update Date | 09/05/2018
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Provider Practice Location Address
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Address Line | 101 CENTURY 21 DR STE 112
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City | JACKSONVILLE
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State | FL
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Zip | 32216-9255
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Country | US
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Telephone | 904-570-9776
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Fax |
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Provider Business Mailing Address
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Address Line | 101 CENTURY 21 DR STE 112
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City | JACKSONVILLE
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State | FL
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Zip | 32216-9255
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Country | US
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Telephone | 301-538-0693
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Fax |
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Authorized Official
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Title or Position | PRESIDENT / DIRECTOR OF ABA
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Name | CURTIS BENJAMIN WOJNAR
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Credential | M.ED., BCBA
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Telephone | 301-538-0693
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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 | 1-11-8870
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License Number State | FL
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