Provider Demographics
NPI:1346584117
Name:SPEER, ELIZABETH JANE (MED, BCBA)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:JANE
Last Name:SPEER
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:JANE
Other - Last Name:RINKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24125 DRAKE RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-3108
Mailing Address - Country:US
Mailing Address - Phone:248-238-9772
Mailing Address - Fax:
Practice Address - Street 1:24125 DRAKE RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-3108
Practice Address - Country:US
Practice Address - Phone:248-238-9772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7401002396103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst