Provider Demographics
NPI:1801626650
Name:SIKORA, LIZA MARIE (MS, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:LIZA
Middle Name:MARIE
Last Name:SIKORA
Suffix:
Gender:F
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 GALLISON HILL RD
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05602-8947
Mailing Address - Country:US
Mailing Address - Phone:802-223-6500
Mailing Address - Fax:
Practice Address - Street 1:288 GALLISON HILL RD
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-8947
Practice Address - Country:US
Practice Address - Phone:802-223-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT146.0134384103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst