Provider Demographics
NPI:1831310671
Name:HUZEVKA, MARJA ROELOFFINA (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:MARJA
Middle Name:ROELOFFINA
Last Name:HUZEVKA
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 1:300 N. 18TH STREET
Mailing Address - Street 2:
Mailing Address - City:PNOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006
Mailing Address - Country:US
Mailing Address - Phone:602-340-8717
Mailing Address - Fax:602-340-8720
Practice Address - Street 1:300 N. 18TH STREET
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006
Practice Address - Country:US
Practice Address - Phone:602-340-8717
Practice Address - Fax:602-340-8720
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst