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General NPI Number Information
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NPI Number | 1417681628
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Entity Type | Individual
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Provider Name | ELIZABETH HINTZ BCBA
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Gender | Female
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Dates
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Enumeration Date | 07/13/2022
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Last Update Date | 07/13/2022
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Provider Practice Location Address
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Address Line | 1020 W HISTORIC MITCHELL ST
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City | MILWAUKEE
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State | WI
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Zip | 53204-3307
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Country | US
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Telephone | 414-251-1782
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Fax |
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Provider Business Mailing Address
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Address Line | 1320 S 1ST ST UNIT 218
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City | MILWAUKEE
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State | WI
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Zip | 53204-2473
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1001-140
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License Number State | WI
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