Provider Demographics
NPI:1508498064
Name:GRESZLER, ERIKA CECILE (BCBA)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:CECILE
Last Name:GRESZLER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 BROAD STREET
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420
Mailing Address - Country:US
Mailing Address - Phone:978-732-3982
Mailing Address - Fax:888-900-0128
Practice Address - Street 1:501 GRANARY RD
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-3042
Practice Address - Country:US
Practice Address - Phone:410-836-7700
Practice Address - Fax:888-900-0128
Is Sole Proprietor?:No
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLBA170103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst