Provider Demographics
NPI:1457181679
Name:ZBIKOWSKI, CHARISSA (BCBA)
Entity type:Individual
Prefix:
First Name:CHARISSA
Middle Name:
Last Name:ZBIKOWSKI
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 1:933 RUBBER AVE APT 3P
Mailing Address - Street 2:
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-3635
Mailing Address - Country:US
Mailing Address - Phone:203-819-6738
Mailing Address - Fax:
Practice Address - Street 1:933 RUBBER AVE APT 3P
Practice Address - Street 2:
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-3635
Practice Address - Country:US
Practice Address - Phone:203-819-6738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1-14-15470103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst