Provider Demographics
NPI:1780862458
Name:DUIJZER, ERICA DIANE (BCBA)
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:DIANE
Last Name:DUIJZER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MS
Other - First Name:ERICA
Other - Middle Name:DIANE
Other - Last Name:POZZIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:1451 W BELLE PLAINE AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-7164
Mailing Address - Country:US
Mailing Address - Phone:815-674-6216
Mailing Address - Fax:
Practice Address - Street 1:5220 6TH STREET FRONTAGE RD E STE 1700
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62703-5771
Practice Address - Country:US
Practice Address - Phone:773-415-5501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-05
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst