Provider Demographics
NPI:1386297034
Name:ROUNTREE, ELIZABETH C (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:C
Last Name:ROUNTREE
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:979 PYRAMID WAY STE 115
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-3172
Mailing Address - Country:US
Mailing Address - Phone:775-657-8309
Mailing Address - Fax:
Practice Address - Street 1:979 PYRAMID WAY STE 115
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-3172
Practice Address - Country:US
Practice Address - Phone:775-657-8309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-22
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
NVLBA0261103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician