Provider Demographics
NPI:1962791434
Name:BEUG, JACQUELINE M (BCBA, LBA)
Entity type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:M
Last Name:BEUG
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10574 MOSS WOOD CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-4148
Mailing Address - Country:US
Mailing Address - Phone:775-843-7574
Mailing Address - Fax:775-448-6758
Practice Address - Street 1:10574 MOSS WOOD CT
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-4148
Practice Address - Country:US
Practice Address - Phone:775-843-7574
Practice Address - Fax:775-448-6758
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLBAT012511103K00000X
NVLBA0018103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1962791Medicaid
NV12205435OtherCAQH
NV9005056476Medicaid