Provider Demographics
NPI:1508673328
Name:CALZADILLA, CHRISTINA (BCBA-LBA)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:CALZADILLA
Suffix:
Gender:F
Credentials:BCBA-LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 371
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06795-0371
Mailing Address - Country:US
Mailing Address - Phone:860-334-9463
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 371
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:CT
Practice Address - Zip Code:06795-0371
Practice Address - Country:US
Practice Address - Phone:860-334-9463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2014103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst