Provider Demographics
NPI:1114325214
Name:ZAWISZA, PATRICIA (BCBA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:ZAWISZA
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3034 TIMBERLANE AVE
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-3731
Mailing Address - Country:US
Mailing Address - Phone:540-491-9599
Mailing Address - Fax:
Practice Address - Street 1:3034 TIMBERLANE AVE
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-3731
Practice Address - Country:US
Practice Address - Phone:540-491-9599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000084103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst