Provider Demographics
NPI:1427571215
Name:BOZIWICK, ANNA (BCBA)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:BOZIWICK
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 1:37 TALCOTT RD STE 114
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-2094
Mailing Address - Country:US
Mailing Address - Phone:802-662-7831
Mailing Address - Fax:802-662-7834
Practice Address - Street 1:37 TALCOTT RD STE 114
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-2094
Practice Address - Country:US
Practice Address - Phone:802-662-7831
Practice Address - Fax:802-662-7834
Is Sole Proprietor?:No
Enumeration Date:2017-07-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-17-26120OtherBACB