Provider Demographics
NPI:1174310254
Name:CAPOZZI, LIZA A
Entity type:Individual
Prefix:
First Name:LIZA
Middle Name:A
Last Name:CAPOZZI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4512 TESLA PARK DR UNIT 108
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-8013
Mailing Address - Country:US
Mailing Address - Phone:223-269-8008
Mailing Address - Fax:
Practice Address - Street 1:3317 MASONBORO LOOP RD UNIT 150
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28409-2970
Practice Address - Country:US
Practice Address - Phone:910-599-2230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician