MEDICARE: DEVYN MAREE ELLIOTT M.ED., BCBA, LBA

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
1	103K00000X	Behavior Analyst		TX
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1740887926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEVYN MAREE ELLIOTT M.ED., BCBA, LBA

Provider Business Mailing Address
First Line	:	11551 FOREST CENTRAL DR STE 129
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-3969
Country	:	US
Telephone Number	:	214-802-4460
Fax Number	:

Provider Business Practice Location Address
First Line	:	11551 FOREST CENTRAL DR STE 129
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-3969
Country	:	US
Telephone Number	:	214-802-4460
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2020
Last Update Date	:	06/27/2024

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Directions to “ DEVYN MAREE ELLIOTT M.ED., BCBA, LBA” Practice Location

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