Crystal Lake Supportive Environments

NPI #1932535184 in Orlando, Florida

Provider Information

NPI Number: 1932535184
Entity Type: Organization
Organization Name: Crystal Lake Supportive Environments
Primary Specialty: Behavior Analyst
Enumeration Date: Sep 19, 2013
Last Updated: Nov 18, 2013

Practice Location

Address: 2710 STATEN AVE
Address 2: SUITE A
City: Orlando
State: Florida
ZIP Code: 32804-4211
Phone: (407) 965-3018

Authorized Official

Name: MR. CRAIG COOK, PH.D., BCBA-D
Title: EXECUTIVE DIRECTOR
Phone: (407) 965-3055

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary

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