Provider Demographics
NPI:1144563388
Name:WILLIAMSON, ELIZABETH ESTELLE (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ESTELLE
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 CENTER DR APT 612
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-8938
Mailing Address - Country:US
Mailing Address - Phone:661-361-3980
Mailing Address - Fax:
Practice Address - Street 1:2115 BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057
Practice Address - Country:US
Practice Address - Phone:323-938-3434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-05
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst