Provider Demographics
NPI:1376136317
Name:CRISAFULLI, JOZIE (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:JOZIE
Middle Name:
Last Name:CRISAFULLI
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:MISS
Other - First Name:JOZIE
Other - Middle Name:
Other - Last Name:CRISAFULLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BCBA, LBA
Mailing Address - Street 1:33303 SE 124TH ST
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-8741
Mailing Address - Country:US
Mailing Address - Phone:206-799-7831
Mailing Address - Fax:425-355-4567
Practice Address - Street 1:33303 SE 124TH ST
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-8741
Practice Address - Country:US
Practice Address - Phone:206-799-7831
Practice Address - Fax:425-355-4567
Is Sole Proprietor?:No
Enumeration Date:2021-02-19
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1-21-47606103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst