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NPI Code Detail

MEDICARE: DENISA RIZVIC BCBA

MEDICARE:   DENISA  RIZVIC  BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-23-64828IN

General Provider Information

NPI Number : 1891480026
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISA RIZVIC BCBA
Provider Business Mailing Address
First Line : 1824 TOUBY PIKE STE B
Second Line :
City : KOKOMO
State : IN
Zip : 46901-2573
Country : US
Telephone Number : 765-628-7400
Fax Number :
Provider Business Practice Location Address
First Line : 4118 N CLINTON ST
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-1210
Country : US
Telephone Number : 260-373-1050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2023
Last Update Date : 04/05/2023

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