Provider Demographics
NPI:1568951754
Name:KAZARAS, ALLISON (BCBA)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:
Last Name:KAZARAS
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 1:10227 W HAMMOND LN
Mailing Address - Street 2:
Mailing Address - City:TOLLESON
Mailing Address - State:AZ
Mailing Address - Zip Code:85353-1227
Mailing Address - Country:US
Mailing Address - Phone:602-615-9549
Mailing Address - Fax:
Practice Address - Street 1:15820 N 35TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053-7606
Practice Address - Country:US
Practice Address - Phone:866-207-3882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRBT-18-54850106S00000X
AZ1-22-61188103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
RBT-18-54850OtherBEHAVIOR ANALYST CERTIFICATION BOARD
1-22-61188OtherBEHAVIOR ANALYST CERTIFICATION BOARD