Provider Demographics
NPI:1306206206
Name:ELLIOTT, ELIZABETH SINGE (BCBA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:SINGE
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05753-1459
Mailing Address - Country:US
Mailing Address - Phone:802-388-6751
Mailing Address - Fax:802-388-8183
Practice Address - Street 1:67 CATAMOUNT PARK
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-1397
Practice Address - Country:US
Practice Address - Phone:802-388-8188
Practice Address - Fax:802-388-8183
Is Sole Proprietor?:No
Enumeration Date:2016-03-04
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT11417751103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst