Provider Demographics
NPI:1316440167
Name:HEATH, ELIZABETH (BEHAVIOR ASSISTANT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:HEATH
Suffix:
Gender:F
Credentials:BEHAVIOR ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:864 THISTLE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING CREEK
Mailing Address - State:NV
Mailing Address - Zip Code:89815-7334
Mailing Address - Country:US
Mailing Address - Phone:775-340-6261
Mailing Address - Fax:
Practice Address - Street 1:864 THISTLE DR
Practice Address - Street 2:
Practice Address - City:SPRING CREEK
Practice Address - State:NV
Practice Address - Zip Code:89815-7334
Practice Address - Country:US
Practice Address - Phone:775-340-6261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst