Provider Demographics
NPI:1952007619
Name:LUZZE, NASIPH LUSWA
Entity Type:Individual
Prefix:
First Name:NASIPH
Middle Name:LUSWA
Last Name:LUZZE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:NABIRAH
Other - Middle Name:
Other - Last Name:NAKIBIRANGO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:266 WAVERLEY ST APT 517
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-7625
Mailing Address - Country:US
Mailing Address - Phone:781-350-6646
Mailing Address - Fax:
Practice Address - Street 1:266 WAVERLEY ST APT 517
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-7625
Practice Address - Country:US
Practice Address - Phone:781-350-6646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12147936103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst