MEDICARE: MRS. ELIZABETH ANN KITE BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-14-10294	TX

General Provider Information

NPI Number	:	1992240006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH ANN KITE BCBA

Provider Business Mailing Address
First Line	:	7108 S KANNER HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34997-7462
Country	:	US
Telephone Number	:	979-575-6357
Fax Number	:

Provider Business Practice Location Address
First Line	:	5738 FOREST TIMBERS DR
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77346-1933
Country	:	US
Telephone Number	:	979-575-6357
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2016
Last Update Date	:	07/27/2020

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