Provider Demographics
NPI:1992281158
Name:BROWN-MILLER, ELIZABETH (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:BROWN-MILLER
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 1:310 W CENTRAL TEXAS EXPY STE 4
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76541-2573
Mailing Address - Country:US
Mailing Address - Phone:254-833-8800
Mailing Address - Fax:254-833-8801
Practice Address - Street 1:310 W CENTRAL TEXAS EXPY STE 4
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-2573
Practice Address - Country:US
Practice Address - Phone:254-833-8800
Practice Address - Fax:254-833-8801
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-11
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2789103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1598345779OtherGROUP NPI
TX2789OtherTEXAS DEPARTMENT OF LICENSING AND REGULATION