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NPI Code Detail

MEDICARE: ELIZABETH HENRY MS

MEDICARE: ELIZABETH HENRY MS
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1366634529
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH HENRY MS
Provider Business Mailing Address
First Line : DEPT LA 22763
Second Line :
City : PASADENA
State : CA
Zip : 91185-2763
Country : US
Telephone Number : 866-523-4268
Fax Number :
Provider Business Practice Location Address
First Line : 3070 RIVERSIDE DR # 200
Second Line :
City : COLUMBUS
State : OH
Zip : 43221-2547
Country : US
Telephone Number : 614-208-9363
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2007
Last Update Date : 03/02/2022

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