Provider Demographics
NPI:1184455982
Name:KENSINGER TOSI, MARISA (BCBA)
Entity type:Individual
Prefix:
First Name:MARISA
Middle Name:
Last Name:KENSINGER TOSI
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 1:611 LAKE LOUISE RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:PA
Mailing Address - Zip Code:18612-6069
Mailing Address - Country:US
Mailing Address - Phone:570-905-0110
Mailing Address - Fax:
Practice Address - Street 1:611 LAKE LOUISE RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:PA
Practice Address - Zip Code:18612-6069
Practice Address - Country:US
Practice Address - Phone:570-905-0110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-24-74662103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst