Healthcare Provider Details

I. General information

NPI: 1306368873
Provider Name (Legal Business Name): ELIZABETH ANN HAND RBT, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELIZABETH ANN DRAGOO BETSY ANN DRAGOO

II. Dates (important events)

Enumeration Date: 07/16/2017
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3621 MARION LN
LAS CRUCES NM
88012-7579
US

IV. Provider business mailing address

6201 ALTA MONTE AVE NE
ALBUQUERQUE NM
87110-2101
US

V. Phone/Fax

Practice location:
  • Phone: 404-780-3242
  • Fax:
Mailing address:
  • Phone: 404-780-3242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-75265
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: