Provider Demographics
NPI:1033897137
Name:SIZA ES
Entity Type:Organization
Organization Name:SIZA ES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD
Authorized Official - Prefix:MRS
Authorized Official - First Name:THULI
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTHELEZI
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBS
Authorized Official - Phone:484-757-5538
Mailing Address - Street 1:5 GREAT VALLEY PKWY STE 270
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-1426
Mailing Address - Country:US
Mailing Address - Phone:484-757-5538
Mailing Address - Fax:
Practice Address - Street 1:5 GREAT VALLEY PKWY STE 270
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-1426
Practice Address - Country:US
Practice Address - Phone:484-757-5538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty