Provider Demographics
NPI:1033802905
Name:CAZALES AUTISM SERVICES
Entity Type:Organization
Organization Name:CAZALES AUTISM SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CAZALES
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:203-606-1676
Mailing Address - Street 1:2704 N OAK ST BLDG A1
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-5901
Mailing Address - Country:US
Mailing Address - Phone:203-606-1676
Mailing Address - Fax:229-598-0557
Practice Address - Street 1:2704 N OAK ST BLDG A1
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-5901
Practice Address - Country:US
Practice Address - Phone:203-606-1676
Practice Address - Fax:229-598-0557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-29
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty