Provider Demographics
NPI:1821220690
Name:LOZITO, TARA (MS, BCBA, COBA, LBA)
Entity Type:Individual
Prefix:MS
First Name:TARA
Middle Name:
Last Name:LOZITO
Suffix:
Gender:F
Credentials:MS, BCBA, COBA, LBA
Other - Prefix:MS
Other - First Name:TARA
Other - Middle Name:J
Other - Last Name:WEBSTER-LOZITO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, BCBA
Mailing Address - Street 1:7342 WRIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44146-5456
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7342 WRIGHT AVE
Practice Address - Street 2:
Practice Address - City:OAKWOOD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44146-5456
Practice Address - Country:US
Practice Address - Phone:407-353-5168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY273915103K00000X
OHCOBA.329103K00000X
FL1-07-3595103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-07-3595OtherBCBA CERTIFICATE