Provider Demographics
NPI:1437747862
Name:LIZOTTE, JULIA (MA, BCBA, LBA, LABA)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:LIZOTTE
Suffix:
Gender:F
Credentials:MA, BCBA, LBA, LABA
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, BCBA, LABA
Mailing Address - Street 1:163 GORDON AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-9048
Mailing Address - Country:US
Mailing Address - Phone:401-261-7837
Mailing Address - Fax:
Practice Address - Street 1:225 NEWMAN AVE
Practice Address - Street 2:
Practice Address - City:RUMFORD
Practice Address - State:RI
Practice Address - Zip Code:02916-1218
Practice Address - Country:US
Practice Address - Phone:401-270-7110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-31
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI1-20-46812103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst