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NPI Code Detail

MEDICARE: ELIZABETH CLOSIUS SMITH M.S., B.C.B.A

MEDICARE: ELIZABETH CLOSIUS SMITH M.S., B.C.B.A
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 Analyst1-13-14094CT

General Provider Information

NPI Number : 1972938017
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH CLOSIUS SMITH M.S., B.C.B.A
Provider Business Mailing Address
First Line : 24 STONY HILL RD LOWR LEVEL
Second Line :
City : BETHEL
State : CT
Zip : 06801-1166
Country : US
Telephone Number : 203-648-2470
Fax Number :
Provider Business Practice Location Address
First Line : 24 STONY HILL RD LOWR LEVEL
Second Line :
City : BETHEL
State : CT
Zip : 06801-1166
Country : US
Telephone Number : 203-648-2470
Fax Number : 203-826-2256
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2013
Last Update Date : 05/16/2023

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