Provider Demographics
NPI:1972982197
Name:PFISTER, ELIZABETH (BCBA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:PFISTER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 WINESAP RD
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:24572-2977
Mailing Address - Country:US
Mailing Address - Phone:434-942-1197
Mailing Address - Fax:
Practice Address - Street 1:855 WINESAP RD
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:24572-2977
Practice Address - Country:US
Practice Address - Phone:434-942-1197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000601103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0133000601OtherCOMMONWEALTH OF VIRGINIA BOARD OF MEDICINE