Provider Demographics
NPI:1851820179
Name:JUZBA, DIANE M (BCBA)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:M
Last Name:JUZBA
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 1:189 S WESTFIELD ST
Mailing Address - Street 2:
Mailing Address - City:FEEDING HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:01030-2753
Mailing Address - Country:US
Mailing Address - Phone:413-244-1732
Mailing Address - Fax:
Practice Address - Street 1:189 S WESTFIELD ST
Practice Address - Street 2:
Practice Address - City:FEEDING HILLS
Practice Address - State:MA
Practice Address - Zip Code:01030-2753
Practice Address - Country:US
Practice Address - Phone:413-244-1732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst