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General NPI Number Information
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NPI Number | 1750233029
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Entity Type | Organization
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Legal Business Name | SPECTRUM OF INDEPENDENCE
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Dates
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Enumeration Date | 02/10/2026
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 3980 S LAKE DR APT 13
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City | SAINT FRANCIS
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State | WI
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Zip | 53235-5244
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Country | US
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Telephone | 715-697-8926
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Fax |
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Provider Business Mailing Address
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Address Line | 3980 S LAKE DR APT 13
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City | SAINT FRANCIS
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State | WI
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Zip | 53235-5244
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Country | US
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Telephone | 715-697-8926
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Fax |
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Authorized Official
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Title or Position | BOARD CERTIFIED BEHAVIOR ANALYST
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Name | ELIZABETH VERONICA HINTZ
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Credential |
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Telephone | 715-697-8926
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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 |
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License Number State |
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