Elizabeth Pamela Wall, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

660 Pine St
Manchester, NH 03104-3101

Phone

(978) 339-3256

NPI assigned

Jan 3, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Elizabeth Pamela Hawkes Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1760752125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 PINE ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031043101",
            "telephone_number": "978-339-3256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 PINE ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031043101",
            "telephone_number": "978-339-3256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "ELIZABETH",
        "middle_name": "PAMELA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-03",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "HAWKES",
            "middle_name": "PAMELA",
            "credential": "BCBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Anita L Wallace, PHARM.D., CGP
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• Kimberly Pauline Wallace, RPH
• Melissa M. Wallace, PSY.D.

• Behavior Analyst in Manchester, NH
• Providers in Manchester, NH by specialty
• Behavior Analyst in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.