Elizabeth Bennett
Individual provider Active NPI Behavior Analyst · Edgewood, NM
NPI 1043792997 · NPPES record last updated Feb 23, 2022
Key facts
- NPI
- 1043792997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 1-20-44478
- Practice address
- 10 Southwood Dr
Edgewood, NM 87015-7100 - Phone
- (405) 905-0881
- NPI assigned
- Sep 6, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-20-44478 | Yes | |
| Behavior Technician | 106S00000X |
Addresses
Primary practice location
10 Southwood Dr
Edgewood, NM 87015-7100
Mailing address
9930 N El Uno Minor
Tucson, AZ 85743-9788
Phone (140) 590-5088
Other providers in Edgewood, NM
- Jolene Alisandra Aragon-Rosales
- Kirsten Asbury
- At Home Geriatric Counseling and Consultation
- Cynthia Batie
- Faith Beck
- Liza Black
- Thomas Black
- Eva Mae Blakely
- Krystal Marie Blanton
- Monica Briones
All providers in Edgewood, NM · Behavior Analyst in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.