Healthcare Provider Details

I. General information

NPI: 1932826674
Provider Name (Legal Business Name): ELIZABETH CRAVER RBT, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 BOONE AIRE RD
FLORENCE KY
41042-1202
US

IV. Provider business mailing address

2529 CHATEAUGAY CT
BURLINGTON KY
41005-9169
US

V. Phone/Fax

Practice location:
  • Phone: 859-444-1866
  • Fax:
Mailing address:
  • Phone: 859-444-1866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-79510
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-22-228532
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: